At Tomorrow Bio, Europe's first biotech company specializing in human cryopreservation, we offer all-inclusive plans. This means that not only do we take care of long-term storage, like most organizations working in the cryonics field, but we also provide Standby, Stabilization and Transportation (SST) and, when suitable, Field Cryoprotection (FCP). What is this practice for? And what advantages does it offer?
The Cryopreservation Procedure
In order to fully understand the benefits of field cryoprotection, we’ll describe a standard case below. Let’s imagine that one of our members is about to require our service. Since we are based in Germany, we will call our imaginary member Florian. Florian is elderly and his health has been deteriorating for some time. Lately, he has been hospitalized. Here the attending physician realizes that Florian’s condition is deteriorating and he might have very little time left. Having read his patient advance directive (PAD), he knows it is time to notify Tomorrow Bio, the cryonics organization that will take care of his cryopreservation after his legal death. After a brief call to the emergency number, the experts decide to send the Berlin SST team with their specially equipped ambulance. Within a couple of hours, the team is on site. Now, it is time to wait.
Standby
Cryopreservation can only take place after the declaration of legal death, which varies depending on the country in which the member dies. Since it’s difficult to predict an exact time of death, our SST teams will travel to the patient’s location ahead of their pronouncement. This phase is called standby and can last hours or, in some cases, days.
Stabilization
The moment Florian's heart stops beating and shows no more signs of life, the medical staff decides that there is nothing more they can do and his legal death is declared according to the criterion of the country and state. Florian is transported into the equipped ambulance, where his body temperature is lowered with a mixture of water and ice.
This is crucial: when the temperature drops, the metabolic activity of the cells decreases with it. This means that their need for oxygen also diminishes. Why is this important? The body's cells need oxygen to function. When this is lacking, they enter a state called ischemia, which leads to cellular degradation and, eventually, death. Cell death, especially in the brain, may complicate future revival. To the point of making it impossible, should the brain be completely destroyed.
To ensure that the remaining oxygenated blood can flow throughout the body, the team uses an automated cardio-pulmonary support (CPS) device. In ideal cases, the patient is also intubated and given respiratory support with oxygen. Finally, the SST team administers a cocktail of medicines that help reduce the occurrence of blood clots and have neuroprotective effects. At this point, the stabilization process is complete. Florian is ready to undergo the cryoprotection procedure.
Field Cryoprotection
Now, as Florian was only a few hours away from the Berlin SST team, reaching him with the equipped ambulance was no problem. At this point, the team has already decided that his cryoprotection will take place on site. The procedure would be done in the medical room of the European Biostasis Foundation (EBF) long-term facility only in the event that the member is in the vicinity at the time of legal death. But as speed is key in this process and it might take some time for Florian and the SST team to reach the building, field cryoprotection is the most efficient option. Even if the patient is stable, any delay in the procedure could lower the final quality of cryopreservation.
Therefore, the SST team starts performing Florian's operation. They access the chest cavity by classic median sternotomy, cannulate the aorta and vena cava, and attach our customized perfusion system. At this point, the team replaces all the blood and water with cryoprotective agents. It’s crucial that as much water as possible is removed from the body since water would freeze and form ice crystals at negative temperatures. And can you imagine what these sharp-edged crystals would do to the surrounding tissues? The aim of the cryoprotection procedure is to prevent this from happening by minimizing ice formation.
Now that Florian is all perfused, the team has to take him to the long-term storage facility, where the medical staff will complete the cryopreservation.
Vitrification
Once there, Florian will be placed in an automated cooling chamber. His body temperature will be lowered to -196°C (or -140°C in the case of ITS). This process can take up to a week to minimize thermal stress. At around -130°C, the body will pass into a glass-like state. Florian is vitrified, metabolic activity is paused and he’s now ready to be stored.
Long-Term Storage
Once the desired temperature has been reached, the final step is to place Florian inside one of the cryogenic storage dewars. There, together with three other full-body patients and several brain-only cryopreservation. patients, he will remain cryopreserved for an indefinite time. One day, if medical technology has developed sufficiently to cure the cause of death and revive him, Florian will have a chance at an extended life in the future.
Field Cryoprotection: The Faster the Better
As shown in the scenario above, in almost all cases the cryoprotection procedure would take place directly on-site, instead of waiting to reach the long-term storage facility. This way, we are able to minimize delays and improve the quality of the cryopreservation.
The advantages of this procedure are:
- It allows the SST team to reduce delays and the risk of ischemic damage to the brain and the body.
- It can be done anywhere, as long as the surgical field, instruments used and the SST team’s personal protective equipment (PPE) is sterilized.
- Tomorrow Bio has portable equipment that can be shipped, for example, by plane.
A possible disadvantage is:
- In case the SST team reaches the patient with the portable equipment, they will have to find a safe space where they can perform the cryoprotection. This could cause logistical problems, which could lead to delays in the procedure.
Conclusion
In human cryopreservation, fast is better. For this reason, having SST teams trained and equipped for field cryoprotection can at times make the difference between high and low quality cryopreservation.
Tomorrow Bio’s SST teams are located in Berlin, in Amsterdam through a partner and we will soon have one in the Zurich area. We work hard to ensure the fastest possible response to our members. Of course, we cannot predict when and where a person's legal death will occur. What we can do is to be prepared for any eventuality.
If this article caught your interest and you would like to know more about our services, have a look at our website. Also, don't miss our articles on cryonics, longevity and futurism that you can read (and listen to!) at Tomorrow Insight.
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