The earlier we start the cryopreservation procedure after legal death, the higher the quality of the preservation of both your brain and body. For this reason, at Tomorrow we are focusing on building standby teams that are highly trained and available 24/7. Likewise, our equipment and ambulance are continuously improved by our medical engineering team with the most up-to-date technologies. Since we want our members to be well informed about every aspect of their cryopreservation, have a look at this article and discover everything about Tomorrow Biostasis’ Berlin-based standby team and ambulance!

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What is a SST / standby team?

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Biostasis members and cryocrastinators are well aware of what the terms SST stands for when talking about cryopreservation. For those who don’t know it yet, here is a short explanation.

Standby: the standby team is sent to the member’s location. In best case scenarios, the team reaches the location before legal death is declared.

Stabilization: after legal death, the team starts the procedure by stabilizing the patient. Firstly, the body’s temperature is lowered with ice and water. A mechanical chest-compression device is used and the team administers the necessary medication. In some cases, the patient is intubated. Only then the water in the body can be replaced with a cryoprotectant solution.

Transportation: once the body is fully perfused and all biological processes are virtually paused, the team transports the member to the long term care facility.

Given current technology, SST (and more specifically stabilization) is the key aspect to ensure a high quality procedure.

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Tomorrow’s Berlin SST team

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At Tomorrow Biostasis we offer a Complete Cryopreservation Program. This means that we don’t only take care of long term storage and possible future revival, as some cryonics companies prefer to do. We also provide our members with comprehensive SST.

At the moment, we have one team in Berlin and one in Amsterdam through a partner. Additionally, we are working on adding more teams in other European countries in order to optimize our local coverage. For example, there will be a standby team located close to EBF’s long term facility in Rafz, Switzerland.

Our Berlin-based SST team consists of our two doctors, Dr. Emil Kendziorra and Dr. Irishikesh Santhosh and one assistant (Rebecca Ziegler in the picture above) with additional people added on a case per case basis. Once alerted, the team is dispatched to the member’s location. Depending on the specific case, the team can:

• Reach the location using Tomorrow’s specialized ambulance. This could be an option when, for example, the worsening of the patient’s condition suggests the patient would probably die in the following day/hours. The team would then drive with the ambulance and be ready to act as soon as legal death is declared.
• Utilize Tomorrow’s Fast Response Vehicle & ultra portable equipment. If there is less time to reach the location (if the patient is about to die or the location is several hours away), the team could choose to use the Fast Response Vehicle instead of the ambulance. And then follow with the ambulance for transport.
• The team could take a flight, train or boat, depending on which option would allow them to reach the patient the fastest. For this reason, when our members travel often (especially outside of Europe) we recommend them to choose a slightly more expensive option - that allows the team to rent a medical private plane if needed.

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Our doctors

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Dr. Emil Kendziorra is Tomorrow Biostasis’ Founder and CEO, as well as being Chairman Of The Board at EBF. Dr. Kendziorra graduated summa cum laude in medicine from University Medical Center Göttingen with a doctoral degree in translational cancer research. His strong background in medicine, cancer research, and entrepreneurship provides a solid foundation on which to build Tomorrow’s ambitious project: the building of a better future.

Dr. Irishikesh Santhosh is our talented new Medical Researcher. With his doctorate degree in medicine at the University of Debrecen and a multiple-year’s experience as a surgical researcher, he is a perfect fit to improve our medical capabilities.

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Tomorrow’s ambulances

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Let’s now have a look at Tomorrow’s SST ambulance. From the outside, it would probably look like a common emergency ambulance - if you are not aware of what “biostasis response” written on the side stands for. Inside though, it’s a bit more special.

Most of the space on the back of the ambulance is occupied by the ice bath mounted on a medical gurney. After legal death, the patient’s body is positioned inside the bath. Here, the temperature is lowered through the use of cold water and ice that is pumped around the body with a focus on the head. At the same time, a cooling mask connecting the patient’s head with the pump helps cool the brain by irrorating the face with ice water. If there is little ischemia (i.e. the body and brain didn’t experience much time without adequate oxygen) the patient is intubated and supplied with oxygen. To improve the cooling rate, a Lucas 2 CPR device is used which provides automated chest compression and establishes  (minimal) circulation. The SST team also uses an intraosseous or intravenous  infusion to give a range of medications.

After initial cooling, the SST team starts the whole-body perfusion process - the most time consuming part of the whole procedure. Big bags of cryoprotectants are hung from hooks on the ceiling of the ambulance. At Tomorrow we use an optimized version of VM1 diluted in four different levels of concentration: 7%, 14%, 43% and 108%. The perfusion system is connected and the cryoprotectants enter the body through the aorta or other major vessels and the blood is being replaced.. Initially, the team perfuses the body with the solution at the lowest percentage. The cryoprotectant percentage goes up while the body temperature goes down. The last cryoprotectant solution used is the 108%. At the end of the procedure, blood and other bodily fluids are entirely replaced by cryoprotectants. The patient is stabilized and ready to be transported to the long term facility, where their temperature will be lowered down to -196 degrees before entering the cryogenic storage dewar.

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There are several other elements in the ambulance that help optimize the procedure. There are two ice boxes to store the ice and cryoprotectant at around zero degrees. There is an active refrigerator for the 108% cryoprotectant solutions that have to stay at -20 degrees. There are screens to monitor temperature, pressure and time. There is a voice recording system, cameras and strong surgical lights. Finally, the ambulance is equipped with sterile Personal Protective equipment (masks, gloves, glasses, scrubs), surgical tools, backup perfusion system, fresh and gray water tanks and much more.

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Some projects our medical engineering team is working on

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Now you know the current state of our ambulance and procedure. Thanks to our own research and engineering, combined with technological and medical advancement from other fields, our technology will get better and better.

At the moment, our engineering team is working on a few projects:

• Modify the aortic cannulation system in order to reduce the time needed to start the perfusion.
• Perfection of the perfusion system.
• Improve the medical cocktail for intraosseous infusion.
• Optimize the portable perfusion system, used by the SST when dispatched without Tomorrow’s Ambulance.

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Conclusion

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Cryopreservation is an advanced medical procedure. Its quality depends on several factors. The time that elapses between the declaration of legal death and the start of the procedure can influence the quality of the perfusion. The temperature and condition of the body also play an important role. Since it’s often hard to control these external factors, at Tomorrow we are training on ideal and non-ideal case scenarios. This means that, whatever will happen in the real world, we are ready to perform the very best cryopreservation possible.

If you have any questions about our ambulance and SST team, feel free to schedule a call with us. If you feel now ready to take the leap and join our community, sign up here!