X-Message-Number: 16152
From: 
Date: Sun, 29 Apr 2001 00:19:35 EDT
Subject: (no subject)

Kryos News #2

New Facility Update

Construction and outfitting of the new Kryos facility is now well underway. 
We hope to be through with the most tedious work (plumbing, casework, wiring 
and the like) within about 3 weeks. 

After that we will begin moving in equipment and setting up for our 
preliminary "validation runs" to ensure that we can deliver the currently 
medically reversible parts of the procedure with high quality. To many 
readers the notion that any part of human cryopreservation procedures are 
reversible will come as a surprise. However, recovery of healthy animals from 
a period of cardiac arrest followed by resuscitation and cardiopulmonary 
bypass has been routine for several years. Furthermore, as long as 9 years 
ago Biopreservation, Inc. demonstrated consistent long term survival of dogs 
following 5 hours of bloodless perfusion at a temperature of few degrees 
above the freezing point of water.

Before we receive our first human patient, we plan to simulate all the 
procedures of cryotransport and perfusion using an animal model. If our 
procedures are as successful as we hope, we will resuscitate our animal 
subject with no residual damage.

We have been repeatedly asked if Kryos services or the Kryos facility will be 
available to other cryonics organizations on a contract basis? The answer is 
that once we are operational we will open the facility on a contract basis 
for use by any qualified cryonics society that may wish to use it. Some 
organizations with no facilities in the state of California may find this 
desirable for regulatory reasons, among others. By way of example, just 
recently a cryonics organization was faced with a situation where a patient 
experienced legal death after the Department of Health Services Vital 
Statistics Office had closed. Legally it is all but impossible to move a 
"body" out of California without a removal or burial transit permit. 
Fortunately, this patient was a neuropatient and the solution to the problem 
was cephalic isolation in a local mortuary and transport of the patient out 
of state as a cephalon as opposed to a whole body. 

Obviously, this would present a problem for whole body patients. The more 
regional facilities which exist that are capable of administering high 
quality treatment including proceeding to vitrification (where appropriate) 
the better the level of care will be for cryopatients everywhere.

Questions About Kryos

We've received a lot of questions about Kryos and have done our best to 
answer them individually. However, this is not a very efficient way to go 
about it, and the primary reason for Kryos News is to serve exactly that 
function. With this in mind we thought we'd tackle the most frequently asked 
questions (so far).

Will Kryos have access to state-of-the art vitrification technology?

We are confident that we will be offering this technology, since we have 
satisfied two of three conditions imposed by 21st Century Medicine, and 
expect to have no difficulty meeting the third.

What kind of services will Kryos offer?

We plan on being a full service cryopreservation organization. By this we 
don't mean that we will offer services other than those focused on human and 
companion animal cryopreservation. We believe that the job of delivering, let 
alone perfecting clinical cryopreservation is so great that the only business 
of Kryos is the cryonics business.
 
What specific services will Kryos offer?

We plan to offer both whole body and neuro cryopreservation. Our first and 
most urgent focus will be on validating the extent to which current 
neurovitrification techniques are effective in the clinical setting. While 
several human neuropatients have been treated with a vitrification protocol 
it is difficult to be certain to what extent ice formation was suppressed. 
This is a more difficult problem than it might at first seem to be. 

The typical way that failure to vitrify is established is by carefully 
recording the cooling curve of the specimen or patient being vitrified. If 
vitrification fails ice will form and ice formation results in the release of 
heat which can be seen as a plateau or "bump" on the otherwise smooth cooling 
curve. This is a very useful indicator of a major failure of vitrification.

Unfortunately, in the real world cryoprotective distribution may be 
inhomogenous and freezing of small areas of tissue may occur over a range of 
temperatures. Also, some tissues may experience partial freezing, again 
occurring slowly during cooling and not generating enough heat to be detected 
by temperature probes placed in very well perfused tissues. In the laboratory 
the amount of ice formed can be measured by a technique called direct 
calorimetery where the total amount of heat removed from the specimen can be 
directly measured. Unfortunately, this technique is not very practical for 
clinical application. Thus, other techniques will have to be used. Kryos has 
developed several approaches to validating that vitrification is occurring 
uniformly in the patient as well as identifying areas where freezing is 
occurring. 

We are particularly concerned that ice formation may still be occurring in 
areas of the brain such as the white matter (which is very poorly perfused 
compared to the gray matter and also consists of relatively water-impermeant 
myleinated axons) and in the brain tissue adjacent to the fluid-filled 
cerebral ventricles. We are also concerned about the retina of the eye due to 
the presence of large amounts of water in the non-perfused gel of the 
vitreous humor. With rapid advances in stem technology and in engineered 
tissues it may be possible to replace any tissue which is too badly damaged 
with the exception of the brain. Our focus will thus be first and foremost on 
the brain the rest of the nervous system.

Once we have validated neurovitrification we will endeavor to try to extend 
vitrification to as many organs in the whole body as possible. We are 
relatively unconcerned about modest amounts of ice formation in some tissues, 
but we want to overcome large-scale freezing in vital organs and especially 
avoid failure of vitrification in areas that are vascular "dead ends" such as 
the chambers of the heart and the pulmonary circulation. 

We plan on offering both neuro and whole body storage. Initially we will be 
able to offer low fracture or fracture free storage only to neuropatients. A 
major obstacle to be overcome, aside from the need for stable and safer 
higher storage temperatures, is to avoid fracturing as a result of the very 
high temperature difference between the surface and core of the patient 
during external cooling. With current vitrification techniques it is 
necessary to cool the patient very rapidly to avoid ice nucleation (which 
necessitates very high rates of rewarming if freezing is to be avoided during 
revival) or worse, actual freezing. We believe we have approaches which will 
prevent fracture-associated injury during cooling. These will need to be 
validated in a clinically relevant model.

The next objective will to extend this technology to whole body patients. We 
understand that a major effort to achieve whole body vitrification will be 
undertaken by a non-cryonics related organization sometime in the next year. 
This is good news for Kryos since it will allow us to focus our efforts on 
service delivery, marketing, and research to further improve brain viability.

We will also be offering Standby (both local and remote) and vastly improved 
transport technology. Current transport techniques fail to prevent an 
enormous amount of both gross and molecular-level damage which occurs as a 
result of ischemia (interrupted blood flow) following legal death. This 
damage is not only of direct concern, but has possible indirect consequences 
for cryopatients. Ischemic injury seriously interferes with uniform and 
adequate distribution of cryoprotectant resulting in either much addition 
damage during perfusion, and still more damage during freezing or 
vitrification. Indeed, such ischemic changes may prevent many patients from 
being vitrified. In future issue of Kryos News we will be explaining the 
details of these ischemic changes and the approaches we will be using to 
prevent or reverse them. Some of this information is cutting edge science 
which has not previously been disclosed. We find it exciting and we think you 
will too.

Kryos personnel have validated the use of these ischemia inhibiting 
techniques in dogs and other animals and have applied some of the technology 
to one human cryopatient with much improved results (see the Cryopreservation 
Case Report of James Gallagher).

Kryos plans to make this technology available to other cryonics organizations 
through licensing where interest exists.

Finally, as previously mentioned, Kryos will offer companion animal 
cryopreservation.

How much will Kryos' services cost?

We are still in the process of determining our costs. A significant cost will 
be access to the highest quality of vitrification technology. While we have 
no firm numbers at this time we anticipate that there will be significant 
increase in cost over our pre-launch projections. Until this issue is 
clarified we will not be able to give reliable cost figures for the whole 
procedure from Standby to Storage.

Will Standby be part of Kryos' human cryopreservation package?

Yes. We firmly believe that offering cryopreservation without Standby and 
prompt intervention to prevent ischemic injury is like selling a car without 
the engine. Standby will be an integral part of Kryos' program. To this end a 
great of effort will be focused on refining Standby launch criteria and in 
monitoring the patient's condition during the last days and hours of terminal 
illness. Streamlining and automating Transport will a key area of Kryos' 
focus with the effort being on reducing the most expensive element of both 
Standby and Transport: personnel.

Is Kryos a for profit company?

Yes, Kryos is for profit corporation incorporated in the state of Delaware. 
Kryos believes that a profitable human cryopreservation business is possible 
and that the focus of any company offering cryopreservation services should 
be just that. We believe that the best way to achieve high quality service is 
to use the profit motive tempered with the years of experience Kryos' 
personnel have in delivering cryonic care. 

When will non-US services be available?

This will be an extended process. To a great extent how fast things progress 
will depend upon the efforts exerted by our potential customers outside the 
US. Our first focus will on Canada because it closer and easier to deal with 
logistically. We had hoped to be able to deliver services to the UK at almost 
the same rate, however we understand that the Alcor UK facility is being sold 
and there will be a protracted period of time where no physical plant exists 
which is suitable for delivery of vitrification. 

Other problems also appear to exist in the UK which may delay deployment of 
services there for some time to come. We find this situation bordering on the 
tragic. Unfortunately, there appears to be little that can be done to avert 
the dismantling of the UK facility which will preclude early deployment of 
vitrification and advanced Transport technology for the foreseeable future.

Do we need help?

Many people have asked if we can use assistance of various kinds? The answer 
is "Yes!" We aren't proud and we aren't prejudiced. We don't care what 
cryonics affiliation you have. We don't see Kryos as a negative to any 
existing cryonics organization. In fact, quite the reverse. The approach we 
are taking will be unique; otherwise we wouldn't bother with all this effort! 
We need help in many areas running the gamut from high level technical skills 
to a good used coffee maker. If you can help, let us hear from you. In the 
next issue of Kryos news we'll run a short list of nontechnical things we 
need. Starting a new cryonics business is a lot like setting up a new 
household. You may most of the furniture and appliances, but you still have 
to spend a fortune on garden hoses, household cleaners, and other "little 
things" that we take for granted because we've accumulated them slowly over 
time. Those little things add up to a fair amount of money. 

We hope the above answers most of the questions many of you have. If you have 
questions we have not addressed, please ask us and we will do our best to 
answer them in future issues of Kryos News. Just write to E. Shaun Russell 
at:  with questions or suggestions. 

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