New Delhi: Dr Himanshu Bansal, principal investigator of the Indo-US mission, is working on an ambitious venture to infuse life into patients declared brain-dead.
The project is being collaborated with an Indian biotech company, Revita Life Sciences, and US-based firm Bio Quark. Initially, the study will be carried out in India and thereafter bilaterally.
The first stage of the clinical trial named ‘Multi-modality Approach to Reverse Brain Death’ will be conducted at Anupam Hospital run by Dr Bansal in Rudrapur, Uttarakhand.
Dr Bansal has been collaborating since 2005 with various centres in India and abroad and is involved in tests related to stem cells in neurodegenerative disorders.
He claims that the team has got some very encouraging results in patients in coma and that they have been able to revert those brain-dead-subjects into a stage of consistent vegetative state, as of now. The multi-modality approach could be the path to a medical breakthrough, and will open the door for future research and show that all damage in the body is reversible, if treated aptly.
He speaks to Gulf News in an exclusive interview.
How did you and other scientists come to the conclusion that a coma patient’s nervous system can be brought back to life?
Dr Himanshu Bansal: There are numerous versions in brain death diagnosis with different countries having varied parameters. We, like many other scientists across the globe, have got anecdotal success in the past three years to get life back of patients diagnosed as clinically dead. I can cite the case of a 10-month-old boy who was found submerged in a bathtub and 42 hours after the incident, fulfilled all criteria for brain death according to Canadian Neurological Determination of Death Forum recommendations. He was given cardiopulmonary resuscitation for 37 minutes and began breathing 15 hours later. This was over six years ago and questioned the assumption that brain death was irreversible. While full recovery in such patients is indeed a long-term vision, it is not the core focus of our study, but a bridge to such an eventuality. Cases and results over the years highlight the fact that in this field of severe disorders of consciousness things are not always ‘black and white’.
What kind of multi-modality test therapies will be applied?
In such a complex disorder, we will apply a combination of therapies, including injecting the brain with the patient’s own stem cells, using a cocktail of peptides and deploy lasers and nerve stimulation techniques, which have shown to bring patients out of coma. Although brain-dead humans are technically no longer alive, their bodies can often still circulate blood and digest food. The patients will have been certified dead and only kept alive through life support. They will be monitored for several weeks using brain-imaging equipment to look for signs of regeneration. This will help future research especially for those who lose their dear ones suddenly.
How close are we from the possibility of bringing the brain-dead back to life?
We stress that it is only the beginning of this type of research. But we also do not view this as a multi-decade endeavour, like, for instance, curing cancer. However, even when we succeed with this first model, it will not mean the end of death. We will have just blurred the lines between irreversible coma [brain death] and coma. [Patients who suffer brain death are not in coma and those in coma may not progress to brain death]. There will still be much more work to do. For example, in the case of a catastrophic brain damage case, as one may find in a war zone or time sensitive death, or in the case of a murder victim, who has bled out, complex re-perfusion [action of restoring the flow of blood to an organ] technology will need to be developed. We have had some preliminary successes in a couple of cases in the Gulf and Europe in close collaboration with local neurointensivists. But these cases are being kept confidential for the time being. All I can say is that those patients are still in minimal conscious state, but may come out of it and have conscious useful human life.
Did it take a lot of convincing to get foreign scientists to agree upon holding the first trial in India, as the general perception is the West is far ahead of us?
No, our scientific and intellectual relationship with the collaborator team has brought together a group of right-minded leaders and we do not look at it with the East versus West perspective. It’s a gradual emergence of scientists and clinicians who are tired of the ‘nothing can be done’ mantra. The global health care system generates $7 trillion annually and it’s time we start looking for scientific truth in an area considered ‘untouchable’ by a majority of the medical establishment. We are being guided by other neurointensivists, including Dr Calixto Machado, senior professor and researcher at the Institute of Neurology and Neurosurgery, Havana, Cuba. He has spent over two decades on the subject.
When will this project commence and have you set a time frame for the results?
We have already been granted ethical permission by the Institutional Review Board, a committee used in research in the US that has been designated to approve, monitor and review research involving humans. The IRB has given the go ahead to enrol 20 patients who have been declared clinically dead from traumatic brain injury and not willing for organ donation. We are open to recruitments and expect to finish enrolment within the next 2-3 months. The results of the six-weeks study will follow by February-March 2017.
Wherefrom do you expect to get 20 patients, given that Indians aren’t too forthcoming even as regards organ donation for various reasons?
On the contrary, we are being flooded with queries. A vast number of families are currently taking care of their loved ones who are brain-dead and we are hopeful of them coming forward to help us in this research project.
Once you meet with success, what about a patient’s memory? Will it be erased and the person restart life all over again?
We are excited that our research could be the answer to such questions. Based on several factors, we are placing our bets that the human mind is much more than the ‘connectome’ [brain connection] and that memory will be a recoverable commodity over the time.
PROFILE
• Dr Himanshu Bansal was born on September 23, 1970 in Rudrapur in Nainital, Uttarakhand.
• He completed his MBBS and MS from King George’s Medical College in 1993 and 1997, respectively.
• A consultant in regenerative medicine at the Institute of Spinal Injury and Stem Cell Research, Rudrapur, he developed a protocol to treat methanol induced blindness and reported the first successful case in the world — 2011.
• He has pioneered several new protocols for treatment of spinal cord injury, cerebral palsy and other neuro-generative disorders.
• He has undertaken research fellowships in institutions including: Aarhus University Hospital, Denmark, Guy’s Hospital Kings College, London, Wurzburg University Hospital, Germany, Osaka City University Hospital, Japan and Reeve-Irvine Research Centre, United States.
