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全球首例"换头术"将实施 费用7000万元(图)

2015-04-10 09:21:51   新京报

但头部依然是全身最特殊的地方,头部移植的最大两个挑战,除了因复合组织而产生的免疫系统排斥反应之外,另一个就是中枢神经系统的连接。

人脑与脊髓连接,组成人体的中枢神经系统,是整个神经系统的控制中心。和人体其他一些神经不同,中枢神经一旦被切断,将不会生长,其功能得不到恢复。

对于这一问题,卡纳维洛自信地解释,受体和供体两者的脊髓末端可以像两束意大利面一样绞起来,他将使用一种名为聚乙二醇的化学物质冲洗融合的区域,并持续注入好几个小时,最终,这种化学物质可以像胶水让两端脊髓融合,就像冲过热水后,两段干的意大利面黏在一起一样。此外,还可以采用注入能够自我更新的干细胞的方法让脑髓跟脊髓连接。

曾成功进行手移植手术的任晓平说,的确,传统上认为中枢神经是没法恢复的,“胳膊上的神经能接上,但中枢神经不能再生,接完了不能活,不能恢复功能。”但近十年科技发展在逐步推翻这个观念,“比如用干细胞,电刺激,特殊的聚乙二醇等,都在慢慢否定中枢神经不可恢复论,但这还需要时间验证。”他说,挑战中枢神经再生功能也是其所在实验室当前最重要的研究。

释疑3 “身首异处”是否可能存活?

脑部移植类似高位瘫痪,该类病患生命最多一般持续数月

在任晓平看来,卡纳维洛能够去挑战现代医学的“终极挑战”,有着很大的勇气,他说,如果能做成人脑移植的第一例,也意味着现代医学的重大突破。

他表示,虽然这项手术在理论技术上可以实现,但因缺乏客观的实验室数据,还是存在很大的风险。脑部移植到目前为止也只有小鼠实验,即使是他们所做的小鼠实验,也只进行了短期的观察,没有长期的观察,而到现在,也尚未有做猪、猴等更高级动物的实验。

“免疫系统的排斥性反应还是要长期观察才能出现的,术后不会很快出现。”他说,“中枢神经的恢复,也很有可能使得病人瘫痪。”

任晓平介绍,从目前骨科高位瘫痪治疗的情况比较来看,很多人因车祸等原因致大脑和脊椎被切断,这些病人中,“三分之一在入院前或到医院后很快就死亡,三分之一入院几个礼拜后死亡,还有三分之一在几个月之后因为没有中枢神经支配,产生并发症死亡了。”而脑部移植就是一种类似高位瘫痪的情况。不过由医生有意制造的切割,可能在刀子产生的损伤上稍微得到控制。他认为,当前做脑部移植,手术当时成功的可能性非常大,“术后恢复意识及智力应该没问题,但恢复身体感觉和运动功能不确定”,这也就是由于中枢神经功能未能或有可能即将突破的挑战。

释疑4 是否有违伦理,造出科学怪人?

学界:手术尚未有科研正当性

A和B变成了一个人,这个拥有A的头脑和B的身体的人到底是谁?这一手术还面临着伦理问题。

这个计划遭到了医学界、伦理界和不少媒体的强烈反对。美国神经外科医学会主席说:“我不希望这事发生在任何人身上。我不会允许任何人对我做这样的事,因为有很多事情比死还难受。”

“这是不是一个愚人节玩笑?”这是北京协和医学院教授,伦理学家翟晓梅听到此事的第一反应,“要不就是在炒作。”在她看来,这一手术风险很大,安全性得不到保障。翟晓梅认为,如果手术是为获取科学知识,那是为了将知识应用在其他人身上,这时就必须做利益风险评估。如果是为了在临床上解决患者的问题而采取创新性疗法,翟晓梅说,那也需要提供“有道理的方法”,“不是科学家自己说有道理就行了,必须是医学共同体公认的道理。”

不过,在任晓平看来,“人类医学的进步都不是一帆风顺的,临床常常走在伦理的前头。”他说,自己20年前在美国做手移植手术时,当时也有非常多反对意见,说首先需要做大量实验才行,“最后做成功了,很多一开始反对的人后来也认可了。”

那如果他的手术失败呢?这可是生命。对记者的这一问题,任晓平回答:“那就接受失败的风险吧,要挑战世界难题,就得承担相应的风险。”

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