X-Message-Number: 6066
From:
Date: Fri, 12 Apr 1996 11:24:23 -0700 (PDT)
Subject: Trans Time newsletter SCI.CRYONICS
THE TRANS TIMES
Life Extension through Cryonic Suspension
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Volume 5 Number 2 April 1996
Pet Dog Suspended
by Art Quaife, Ph.D.
On Wednesday, February 21, Morgan Haas and her husband James
Hunter phoned me from New York. Their 16 year old female
Chihuahua-Fox Terrier mix was having convulsions, and they
believed she had brain cancer. The dog had been Morgan's pet
since Morgan was nine years old and the dog was a puppy; Morgan
was very attached to her pet. Morgan and James wanted to discuss
suspension arrangements.
TRANS TIME has placed several pets in suspension, but in most
previous cases we have not been contacted until the pet was
already dead. Now we were presented with an opportunity to use a
greatly improved procedure. If it proved necessary to euthanize
the dog, we advised Morgan to ask her veterinarian to heparinize
the dog and conduct a blood washout with Hespan while the dog was
still alive. Our colleagues at BioTime have found that rats can
survive with 80% of their blood replaced with Hextend
(trademark), BioTime's experimental blood substitute which is
similar to Hespan. The procedure we recommended was not very
difficult, but neither Morgan's veterinarian, nor a large
veterinary clinic, would agree to cooperate.
On Saturday, Morgan and James received the result of a CAT scan.
Their dog had cancer leading up its nose and touching on the
brain. The cancer was judged inoperable. Their dog was crying in
pain, and they were desperate to know what to do.
I contacted the surgeon that heads our suspension team, who also
performs contract animal surgery in his clinic. If the dog could
be brought out to California alive, he agreed to carry out our
full suspension procedure. I also alerted Stephen Kehrer, who is
on the TRANS TIME Board of Directors. In his full-time work, he
regularly washes out and cryoprotects rats with the procedure we
wished to use on the dog. He prepared to work with our surgeon.
TRANS TIME has the right to use BioTime's solution formulations
for cryonics purposes. We keep a supply of blood-substitute and
cryoprotective solution frozen at our lab. Preparation of these
solutions is a lengthy process, but all we need to do before a
suspension is to thaw the solutions in warm water. I packed such
solutions for the trip to the surgeon's clinic.
Morgan and James had the dog anesthetized for the long plane
trip. They and the dog arrived at about midnight. After
completing business arrangements, we took off by car for our
surgeon's clinic, arriving at about 3:00 a.m.
*Procedure*
The following excerpts are adapted from our procedure log.
3:00 a.m. The surgeon administered 750 IU of heparin, and 3.5 cc
of barbiturate to the 2 kg dog. Preparations for surgery began,
and the family said a final goodbye to their pet.
4:02 The surgeon inserted a 6.5 fr. endotracheal tube,
connected to an Ohio ventilator. The ventilator delivered oxygen
and .5% isoflurane anesthetic to the dog. The surgeon inserted
catheters in the jugular vein and the carotid artery.
We began perfusing the dog with our blood substitute. Since the
dog was so much smaller than the human patients we normally
treat, we used a Masterflex roller pump with 1/4" i.d. x 1/16"
wall tygon tubing.
4:30 The dog's blood volume was estimated to be 130 ml. Our
goal was to wash out most of the blood while the dog was still
near normal body temperature. We began perfusing the blood
substitute, which was at room temperature, through the carotid
artery, and allowed the blood to exhaust from the jugular vein.
The surgeon inserted a rectal thermocouple, and attached EKG
leads to monitor the dog's heartbeat.
4:58 The dog was at 29.3 degrees C and 75 ml. of blood-Hextend
had exhausted. We began packing the dog in ice.
5:22 The dog's temperature was 25.1 degrees C, and we
completely surrounded her with ice.
5:37 We have now perfused 350 ml of Hextend, while a total of
220 ml of blood-Hextend has exhausted. We began perfusing a
solution of 50% Z+ and 50% CRYO.
[PHOTO OMITTED]
Dog packed in ice during surgery.
5:42 The dog's heartbeat ceased at 16.7 degrees C. We
disconnected the ventilator.
5:54 We had perfused a total of 275 ml of the 50% Z+ / 50%
CRYO solution, leaving 75 ml in the reservoir. There was 465 ml
of effluent, and the dog was at 12.2 degrees C. We added 925 ml
of pure CRYO to the reservoir, and began perfusing this 3.75% Z+
/ 96.25% CRYO solution.
6:10 We ceased perfusion, having perfused 600 ml of the 96.25%
CRYO solution. The total effluent volume was 1110 ml (about 8.5
blood volumes), and the dog was at 8.6 degrees C.
6:15 The surgeon sutured the neck incision closed.
6:20 We placed the dog in an aluminum brazier, 5.5" high by
10.5" inner diameter. We had foam pads placed above and below the
dog. The brazier was placed within a styrofoam chest filled with
dry ice, to begin freezing the dog. We drove the dog back to the
TRANS TIME laboratory.
*Perfusates Used*
Our blood substitute is a proprietary mixture of salts, sugars,
and starches.
Z+ is an iso-osmotic blood substitute that uses Dextran 40 as the
oncotic agent, and contains no potassium.
CRYO is a 2.8 molar solution with base Z+, but also contains
sucrose, increased glucose, propanediol, and glycerol.
*Freezing and Encapsulation*
11:42 a.m. Dog's temperature was 0.5 degrees C.
8:01 p.m. Temperature was -7.8 degrees C. Dog is frozen.
2/26/96
10:42 a.m. Temperature -71.8 degrees C. This is about as cold as
the dog will get in this chest cooled by dry ice.
Paul Hirsch and Art Quaife worked on modifying the brazier for
use in encapsulation. Paul replaced the lid handle with a chain
handle, drilled holes for bolts running from brazier bottom
through lid top, and notched the lid so the thermocouple could
escape.
2/27/96
3:30 p.m. Morgan and James came to the facility for the final
sendoff. Paul and Art transferred the pet container into our Son
of Kong dewar for long term storage.
*Motivation for Pet Freezing*
Why do people have their pets suspended? In most cases, it is for
the same reasons that people have a family member suspended.
Indeed, many persons consider their pets to be part of the
family.
TRANS TIME maintains several pets, and tissue samples from pets,
in suspension. In each case, the owners are paying for suspension
on a yearly basis. I find it surprising that none of these owners
have made arrangements for their own suspension. This means that:
(1) At the time of their death, unless they have by then paid for
perpetual storage, the pet will be removed from suspension; (2)
Even if they do pay for perpetual storage of the pet, and even if
(say) 100 years from now it proves possible to reanimate the pet,
the owner will not be around to request and benefit from the
reanimation.
For many years cryonicists have debated the advisability of
promoting "cosmetic freezing." Under this option the person would
be frozen less expensively--without cryoprotection--and the
possibility of future revival would not be promoted. Instead the
pitch would be that we can preserve the corpse in nearly the same
state as when the person died, the corpse will not rot away, and
will not be eaten by the worms. Note that people regularly visit
their relatives in cemeteries. (George Burns regularly went to
the mausoleum to talk to Gracie Allen, and survived to age 100.
Any connection?)
Such a "high-tech burial" seems less final than rotting in the
ground, and leaves a corpse that the relative can think
positively about. I believe that this is essentially the
motivation for several of our pet owner clients.
*Reflection on Procedure Used*
Our researchers believe that the procedure we followed for
introduction of cryoprotectant solution into the dog was optimal.
If we had begun introducing the CRYO solution at a higher
temperature, it would probably have caused the heart to stop
beating, which we did not want. If we had waited till a lower
temperature to introduce it, the circulatory system would have
been partially occluded, and distribution of the cryoprotectant
throughout the body would not have been nearly as good. This dog
received the best treatment of any pet or human we have ever
suspended! Today, we don't know how we could have done any
better.
It is ironic that we can deliver a better suspension to pets than
we can to humans. Of course, this is because we can begin the
suspension of pets while they are still alive, with veterinarian
assistance, whereas under current law we cannot do so with
humans. But laws change--see the article "Appeals Court Declares
`Right to Die'" elsewhere in this issue. The time is coming when
we can treat our relatives as well as we can our pets!
May you, and your pets, join us in the glorious future!
[PHOTO OMITTED]
Paul Hirsch and Art Quaife lower pet into capsule
My Job: Patient Transfer
by Paul Hirsch
When you mention cryonic suspension, many people instantly
associate it with frozen people passing monolithic blocks of time
undisturbed, as if in a mausoleum. Our charges wish to have the
term "patient" applied to their current situation. These are not
remains! Ideally the patient is left undisturbed, immersed in
liquid nitrogen. However, like a patient in a hospital, a certain
amount of mobility must be designed into the situation. The
patient is a person that must be looked after through all the
eventualities of passing time.
At this time patient transfer (or having patients at all) is
still not a common occurrence. Each time a patient has been moved
it has been for a different reason. Methods have varied slightly
with each move, because of differing receiving containers. And,
with each move, expertise is developed.
Patients are stored in individual containers within the larger
cryogenic storage capsule. The patient container is a heavy
object, 6 feet or more in length. A small crane with an electric
winch is positioned to lift the container out of immersion in the
capsule. Generally three people, with properly operating
equipment, achieve the lifting: one to operate the crane, and two
to act as spotters watching for trouble. The third person also
holds the boom in place during lifting.
The patient capsule must be lifted above the rim of both tanks,
and must remain suspended in air, while being positioned above
the receiving tank. It usually takes three people to carefully
align the container for final positioning in the receiving
capsule. Once the container comes to rest, it is detached from
the crane's lifting cable.
Even with the best of equipment and safety precautions,
suspending heavy objects in air is dangerous. Also, you have to
watch for liquid nitrogen draining out of the container, and
falling in the direction of your head! Vigilant awareness is a
must.
The extreme cold and weight make lifting the patient container
too awkward by human muscles alone. Ice forms on the outside of
the container, and handles are not used on the sides of the
patient containers, so they may slide easily into position.
Lifting equipment is a must.
There is a definite need to design cryonic storage equipment to
be compatible with lifting equipment or lifting "systems" that
are generally available, as they will always need to be used. For
now, the TRANS TIME crane easily accomplishes the occasional
patient transfer. However in the future, as activity in the
cryonics field accelerates, we may want to consider returning to
the use of narrow-aisle lift trucks (forklifts). [We used
forklifts before we got the crane--Ed.] They can perform lifting,
and also transporting, of patient containers. They can be
configured to act as a self-propelled version of the TRANS TIME
crane for larger or multi room facilities.
Appeals Court Declares `Right to Die'
by Art Quaife, Ph.D.
Many cryonicists support `right to die' laws, for reasons that go
beyond their popular support. Consider the paradigm case of a
cryonicist who is diagnosed with a brain tumor; his doctors tell
him that the tumor will now steadily eat away his brain until in
six months he will be dead. The cryonicist will almost surely
wish to be placed in suspension before that tumor eats away most
of his `identity'. See the article elsewhere in this issue
showing how we were able to treat a dog under essentially these
circumstances. It is very difficult to do the same for our human
clients under current law. Any cryonics organization that
cooperated in placing this client in suspension before his legal
death could be charged with assisting a suicide, or perhaps
murder.
Several cryonics patients have already faced this or a similar
situation, and have chosen to end their (first) lives prematurely
by starving themselves to death. This action appears to get
around the legal problem, but still has the disadvantages that
(1) it is an extremely unpleasant way to end one's life; (2)
since it is still difficult to predict just when the patient will
expire, the cryonics team may not be on hand at maximal
readiness.
The following excerpts, from an article in the March 7, 1996 San
Francisco Chronicle, offer further hope that the law is changing
in our favor.
"The U.S. Court of Appeals in San Francisco struck down yesterday
a Washington state law barring doctor-assisted suicides, becoming
the highest court ever to rule that terminally ill patients have
a constitutional right to decide when and how to die.
"In a powerful opinion comparing the right to die with the right
to refuse medical treatment to have an abortion, the court held 8
to 3 that the state's ban on aiding suicide violates the due-process
rights of those who `wish to hasten their deaths' with
medications prescribed by doctors.
"The ruling is the first on the issue by a federal appeals court.
It casts doubt on the legality of a similar statute in
California, and probably means that an Oregon law allowing
doctors to help terminally ill patients die will be upheld.
"Although the decision applies only to the nine Western states
covered by the court, it may also help attempts to dismiss
assisted-suicide charges against Dr. Jack Kevorkian in Michigan.
In any event, this case--or one like it in New York-will almost
certainly go to the U.S. Supreme Court for final resolution,
perhaps as early as next year."
[FIRST HALF OF NEWSLETTER]
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