LS 142 - The Surgical Future with John LaRocco

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Hello everyone, this is your host, Fernando Aries, in partnership with the Hartman Media Company. Today I have the pleasure to welcome back to the show John LaRocco. John is an amazing guy. He's immersed in a fascinating creating a bionic body system to support a human head and brain. Yes, we are at that stage now. Were discussing it. He holds a provisional patent on a life support system for a full body prosthetic. He's a biomedical engineer with an interest in life support, neuroprosthetics and technologies for rehabilitation. Last time John was interviewed on the show, he talked to Jason about a human head transplant, you know, a year or two ago. John, welcome back. And I just wanted to ask you, where are you located? I like to give that sense of geography to the audience so that we know where you're coming from.

Sure. Right now I'm in Singapore.

Singapore. Okay, John, give us an update on where we are. Jason, you and you talked about this human head transplant. Where are we now as far as that's concerned? I do know of news recently about the Italian professor Sergio Canavero, and he says that will soon be performing the world's first head transplant. And he has gotten quite a bit of media on this. He's mentioned that there was a recent operation at a China clinic, the Harbin Medical University and demonstrated that it's possible to successfully reconnect the spine, nerves and blood vessels to a severed head. What's your take on this?

Well, right now, the actual progress, at least as far as the papers in my correspondence with Dr. Canavero has been Professor Wren and Dr. Canavero have done a transplant on essentially recently deceased Corpses. This is just perhaps speculation on my part, but have you ever heard of the living corpse research?

No, I have not.

Alright. Basically it is sometimes when people donate their bodies, they allow their bodies to be kept alive artificially so that say medical students or professors or researchers could do research on their brain dead bodies, prepping for surgeries, that sort of thing. I believe that if they are going to do a head transplant on a patient, that would probably be where they would start with patients that have donated their bodies to science that match a very select immunological, genetic and physiological compatibilities to try doing a human head transplant before they go with more conventional patients. But for now my understanding is they've done essentially a dry run on two corpses that have been dead for less than 18 hours.

Correct? Yeah. And he did say that will or he will move on to perfecting this procedure with brain dead organ donors very soon. As a matter of fact, there is a person, a 31 year old disabled man, believe his name is Valerie Valery, Spirit or not.

Yes, The Russian guy.

Russian guy. He wants to be the first ever recipient of a head transplant. You know, very articulate person and definitely knows what he wants to do. John, tell us what's so difficult about transplanting a head? You know, I think we as of now do not have a documented successful reconnection of a fully detached spinal cord even. And for a completely severed spinal cord to be brought back to functionality, there's just millions of nerve connections.

Exactly.

They need to be linked back together. And these are very difficult to rejoin. Give us a sense of the size of this problem.

Think of it like this. Everyone is born with a certain number of spinal nerves. And that number will remain constant or decrease due to injury or disease throughout your life. When those spinal nerves are severed, they're pretty much gone. Unless you are very, very lucky. When you have millions and millions of spinal nerves, they control your nervous system, your internal organs, how your body regulates itself, your movements. When those get damaged, that can throw a lot of other systems in your body out of whack. That's why you've got millions and millions of connections. And if spinal nerves go, it's like cutting the power to a major city and you can't reconnect it again. Unless you're either very lucky with surgical procedures or your body finds another way. Which tends to be the very small minority of cases.

Well, not to say the whole psychological rejection aspect of the whole thing, you.

Know, the rejection is actually immunological. When you have tissue that is transplanted from One body to another, it could be an organ. The immune system targets things that don't share its genetic characteristics. That's why transplants between cousins tend to be rejected less often than transplants between strangers.

Well, what I mean, I understand that aspect of it, but what I'm getting at is, I don't know if you heard, but the first successful penis donation was cut short when the patient that received it told doctors to remove his new genitalia. You know, the face transplants pose a similar problem. A head transplant. Basically, the organ recipients, they can take drugs to suppress a rejection of the organ by the immune system. But having a cadaverous face or tissue in a place where you once saw something familiar as defining as in your own head can be deeply troubling. And that's what I was getting at with the psychological reject, which must be something that has to be taken into account.

Exactly. With the psychological factors, though, it also can depend on if you see it on a regular basis, you're going to see your head, you're going to see your genitalia a lot more than you're going to see maybe a transplanted heart or lung, for instance, because the heart of the lung, you could hear it and feel it, but unless it's got some kind of immune inflammation response, you, you're not going to be seeing it on a regular basis like your head or not. But as far as head transplants go, the person would have to get used to a whole different body, maybe a slightly different height than their original body was. That is something that for now is in the realm of science fiction because we don't have any human head transplant people that can really testify to that fact or not.

Yeah, but I don't think it will be long. I think, as we all know, people tend to not understand the concept that the biological timeline is linear, but the technological timeline is exponential. Things happen a lot faster in technology. And discoveries that are made across the world allow scientists and researchers and engineers such as yourself to just stand on the shoulders of the work that other people have done and just very quickly turn. The turnover ratio of new discoveries is just mind boggling, and people can't keep up with it. By the time they hear of a head transplant, they didn't know how much was already being done a year ago when they not necessarily heard about it.

I might contest that to a point, because head transplants have been around since a guy named Dr. White in the 60s and 70s doing the monkey head transplants. A lot of technologies and ideas are actually a Lot older than we might like to consider them. But it's just that a lot of costs of doing these technological things has dropped over the last few decades because of advancements in manufacturing and stuff along those lines. So stuff that might have been really expensive and impractical decades ago now is more accessible and it's easier to attempt that sort of work. Similarly, a lot of technologies can plateau after the easy discoveries. The low hanging fruit has been picked off. That's why reframing an issue or taking an approach that hasn't been done before, there's very few genuinely new ideas. But taking that unorthodox approach can allow you to apply one idea to a different sort of terrain, if you will. That is the thing that really interests me. Can you take an idea out of one area of technology or research and apply it to something different and be successful with it?

Yeah, take ideas that come from science fiction. You know, so many things that you can pick your imagination in books and movies and so on and put them into work. I think that that's very inspiring. Now, John, let me jump into talking about you and your work. I understand you recently came out with some breakthrough research. We've been talking prior to the show about prototype that had some updates. Can you tell us what's going on? What's new in your world?

Sure. The full body prosthetic device that I described earlier, something I kind of designed on my own and had manufactured with some of my own savings. Essentially we designed a vessel that was designed to contain the transplanted organs and spine of a subject animal as well as the head. Essentially we would seal both ends, the head would stick out one end and you'd have a catheter running out the other end. And use this essentially as a surrogate body cavity. That is essentially what was designed and tested. So with the head transplant, you're cutting the spinal cord and you need to reattach it. Here we're basically. We're just trying to transpose the contents of the chest cavity into an artificial substrate.

So you have a prototype now that you can talk about or where is that at?

Yes, I actually can send you the CAD files if you'd like to 3D print it. Basically the small plastic cylinder with a hole in either end. It was made using stereolithography, SLA, a kind of reverse 3D printing where you use a laser to heat up plastic as it kind of rises from a mold. We had a couple of different models we played around with, but in the end we went with a rat sized one. We sent it to Professor Ren's lab. He and one of his grad students managed to test it out on a rat. And that was the work that I presented in a conference in South Korea in July this year. I mean, last year. Still thinking 2017.

Let me sure I get this right. So there is the head of a rat in an artificial body. Essentially, yes.

There's the head of the rat, the spine of the rat, the organs of that rat in the artificial body. One big change that happened, though, is that because of the diaphragm, the muscle that controls the lungs expansion, that was cut during the surgery. So we had to go with an unconventional life support system. We essentially had a larger rat. To give you some numbers, the base rat we used was about 100 grams in weight. The other rat was about 350 grams, much larger. And we essentially used that as a living ventilator to reoxygenate the blood and keep it flowing, in addition to a paracetal pump that would keep the reoxygenated blood flowing from a bigger rat to the rat in the artificial body. Because of the complexity of the system and the angle of the tubing getting a little steep, we had irregular and turbulent flow that caused some blood pressure issues that killed our poor rat after an hour.

So that's very interesting. So life support technology was your biggest issue.

Correct.

And it wasn't so much the connection itself, it sounds like. So do you foresee this life support area as being the focus going forward? You know, how important is this?

Well, the life support. To give you some numbers, the current state of the art for regular surgical life support is called extracorporeal membrane oxygenation. Ecmo, as I kind of touched on last year, ECMO kills half the patients that undergo this procedure, and it gives lasting brain damage to about 40% of the survivors. This is due to things like how it compresses the blood, irregular flow. You also have inflammation issues, a whole lot of raft of nasty things for people who undergo this procedure. But generally, the people who undergo this procedure are already in a bad shape. People, people who need cardiac bypass, people who are bleeding out with their heart and lungs shutting down. So it's a very bad situation compounded by a technology who essentially causes bad things to happen to that remaining tissue.

And it seems to me, and maybe you can correct me on this, but there's, I think, a differentiation when you talk about artificial organ development in general, and that's focus on kind of the cellular and molecular level. But in hearing you talk about this Life support and being able to create viable artificial organs. It requires thinking about the whole system. Right. And I think that that's what you specialize in. You need a framework of some sort.

Correct.

To integrate all of these different parts. Go ahead.

In the body, organs occur as organ systems, not just on their own. This is why I think artificial organ technology has stagnated in recent decades. There's been some really brilliant researchers and some really promising stuff, But a lot of it is focused on one particular organ, because one startup or one research group might not necessarily collaborate with someone who's working on the other component for an organ system. Now, ECMO is essentially building an artificial organ system about the cardiopulmonary system and the circulatory system. This is a case where you have the life support technology literally mimicking the same things that the body does for reoxygenating and moving blood around. And if you could do that with artificial organs, you also could apply that to regular life support. So the framework that I would really use for artificial organ integration would be essentially homeostasis, the way the body can bring certain physiological parameters back within control ranges through negative feedback loops. That I think is the key to getting viable artificial organ systems. Moving from that smaller scale, an individual organ or tissue group, to a larger one.

Yeah, it makes sense. I agree with you. I think the concept of doing a transplant and just giving some drugs to prevent the rejection is narrowly focused, at least from the perspective that you have in the sorts of things that you're trying to achieve. You know, we had an interview not too long ago with the CEO of Bioquark, IR Pastor. Yeah. You're familiar with him, correct?

Yes. He works on some really interesting stuff with the. Essentially the brain rebooting the reanima, I think he calls it, injecting chemicals into people who are brain dead to try and get them active again. Kind of a neural reset button.

Is there an overlap or parts of the work that they do, which is just fascinating as well with what you were trying to do.

The stuff that he's working on is, I think, a bit more advanced than the stuff that I'm doing. He has a whole research company, whereas I'm just organizing a group of fellow research volunteers, kind of doing this on our own dime, in our own time. His stuff is a bit more advanced in terms of their organization because they're essentially going with more tissue engineering, the biological approach, Whereas the approach that I'm really using is more the engineering and mechanical approach. I have talked with Ira before. He's a pretty interesting guy. It's just that for our continued approach, we would need to kind of iron out some of the life support stuff before we would need to worry about rejuvenating organs. There's a lot of people doing SENS research, there's a lot of people doing tissue and engineering research. It's just that in order to bring our stuff to that level where we could work with them, we would need to show more results on our end. There's been a lot more capital and a lot more interest on things like SENS and aging research and all that sort of stuff in recent years, but not as much on the bionic end.

So what's next, John? What are you working on when we have you here next time? What sort of research or opportunities do you think you'd be able to talk about?

Well, a couple of things that I'm planning to do. One thing I have been doing is since July, I've been working on a solution to some of the life support issues. I'm not going to go into too much details because I could bore you guys for another two hours on going into the specifics of it. But essentially it's a way of going about life support through a rejected idea on artificial blood and adapting that as an oxygen supplement rather than a blood substitute. The other thing I'm going to be working on in the near future is a crowdfunding and Patreon campaign to continue funding some of this work because I think that the future of research is going to be more along the lines of what I call citizen science. A lot more people doing hobbyist approaches in their free time. And I don't know if you follow a lot of YouTube or content creators after what they call the adpocalypse online ad revenues getting cut earlier this year, a lot of them started moving to Patreon. I think that scientists using Patreon and similar platforms to fund research projects like this may be the way of the future as far as some of this stuff that's still in its early phases can go.

Yeah, no, I'm familiar with Patreon. I think you got a good point there. That's the democratization of the information being available so easily. And that's just great. A great opportunity for people such as yourself. You can have great ideas, but you do need that support and I think you can get that through the information sharing. Well, John, I know we're coming up to the end of the show. Anything else that you want to leave us with? Sharing URLs any handles. Anything else that you want our audience to remember?

Sure. I would like to thank everyone who made this research possible. I had a very diverse and interesting group of people. I had a former US army medic, an Indian graduate student, and a Kiwi Chinese dentist who all helped make this thing possible with Professor Ren's lab. So I'll also leave off with the URL for a couple of things if you guys are interested. I'm setting up a Patreon to fund some of this artificial body research. And I'm also setting up a place where you can find all the research I've done up till now. I have a paper that I've written up on the artificial body and its results, and I'll leave you the link to the Patreon site if you guys are interested on either. If anyone wants to actually replicate or try to improve upon our rat work, we'd welcome that as well. We'll give you the 3D printing and CAD files for the artificial body. If you guys want to test it.

Out yourselves, that would be quite interesting if we had members of the Artist that take you up on that offer. That's quite amazing. Very specific work. So we can put that URL in the show notes. And I know that you have your personal URL as well. Do you want to share that?

Yeah, just my first name and last name, johnlerocco.com it hasn't been updated in a while, so that's something that's probably going to be changing in the next few weeks as well, because for now I'm just starting a new job, so things have been a little bit busy on my end.

Well, good luck to you in your new job. And again, John LaRocco@johnlarocco.com that's with two Cs, John, it's been a pleasure to have you again on the show, and you have a great day.

Okay, thank you.

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