X-Message-Number: 9403
Date: Fri, 3 Apr 1998 14:45:58 -0500 (EST)
From: Charles Platt <>
Subject: Damage to CI Patients?

At the upcoming Alcor conference, we will hear about progress 
that is being made toward zero-damage human cryopreservation 
by scientists who provide detailed substantiation of their 
work. These reports create a puzzling contrast with Bob 
Ettinger's claims that vastly simpler protocol still produces 
acceptable results at The Cryonics Institute (CI), the 
organization that Bob founded and ran for many years. 
Since Bob has never substantiated his claims with data from 
human cases, and since the claims are contradicted by recent 
research, I feel it is time to ask some questions about CI's 
procedures and their probable effects. So far as I can tell, 
based on elementary knowledge of cryobiology, the procedures 
at CI do not produce acceptable results; on the contrary, I 
believe they inflict substantial damage that could be avoided 
with simple modifications. 
To those who dislike squabbling in cryonics I suggest that 
public disagreement is a normal, integral part of science. 
Indeed, it's a prerequisite for progress. I do not question 
Bob's sincerity, or CI's management; and clearly, CI is the 
most financially secure of all cryonics organizations. I 
simply question the scientific validity of its procedures. 
     1. Damage Caused by Slow Freezing. 
Broadly speaking, the freezing process causes two kinds of 
cell damage: chemical and mechanical. As the temperature 
falls, water is drawn out of cells via osmosis, leaving 
behind increasingly toxic concentrations of salts. A red 
blood cell (one of the more robust types of human cell) can 
only withstand 3 or 4 times the normal concentration of these 
Meanwhile, ice crystals form in the water that gathers 
between the cells, and if these crystals are allowed to grow 
excessively large, they sever long cell processes (such as 
connections between neurons) and literally scramble brain 
structure to the point where reconstruction will be 
problematic. In fact, based on pictures that I've seen, I 
feel that reconstruction of severely scrambled tissue is 
The longer a cell takes to freeze, the more time there is for 
chemical and mechanical damage to occur. (This is why 
vegetables are "flash frozen," minimizing structural damage 
that would make the food "mushy" otherwise.) Also, autolysis 
and decomposition may continue until the temperature drops 
well below zero Celsius; this is another reason why freezing 
should not occur too slowly. 
I would like to ask Bob Ettinger if he is aware of these 
basic facts; and if so, what steps CI takes to freeze 
patients reasonably quickly. 
I have been told that a typical patient at CI is cooled 
merely via air convection, beneath blocks of dry ice. Is this 
true? If so, why doesn't CI use liquid immersion as a simple 
means to achieve much faster cooling? 
Before cooling begins, I understand that CI wraps the patient 
in a sleeping bag. Since the sleeping bag is an insulator, it 
will retard the freezing rate still further. Consequently, I 
believe CI's patients take _one week_ to reach dry-ice 
temperature. This is seven times slower than the rate 
achieved in cases at other cryonics organizations, where 
immersion cooling is used. 
Can Bob confirm that my description of CI procedures is 
correct? if it is, can he explain why CI continues to freeze 
its patients slowly, even though this is known to allow more 
cellular damage to occur?  
     2. Damage Caused by Improper Cryoprotection 
If glycerol is used as a cryoprotectant, its concentration 
should be low initially. A high initial concentration will 
force rapid extraction of water from cells without allowing 
time for the glycerol to replace the water, and the results 
can be devastating. In the words of one cryobiologist, if 
cells are perfused with an initial concentration of 70 
percent glycerol (by volume), "you will kill almost every 
cell on contact because of the rate of fluid extraction." 
Is it true, Bob, that CI uses a concentration even higher 
than this--typically 75 percent glycerol by volume--with no 
attempt to begin at a lower value, regardless of the 
potentially devastating effects? 
The need to increase concentration gradually has been known 
in the cryonics community for many years. For instance, in 
the October, 1988 issue of Cryonics magazine Mike Perry 
wrote: "The considerable osmotic activity of CPAs 
[cryoprotective agents] ... dictates that introduction be 
gradual. This allows time for the agent to diffuse across 
capillary and cell membranes and slowly exchange with 
water.... Too rapid a rate of introduction of CPA will result 
in dehydration (shrinkage) of the cells and injury due to 
osmotic stress." 
Alcor and BioPreservation use a properly instrumented system 
to increase glycerol concentration over a period lasting as 
long as four hours. Also they recirculate the cryoprotectant 
via a closed circuit, to maximize penetration, which will be 
insufficient otherwise. Mike Perry's study, mentioned above, 
concluded that three hours of closed-circuit perfusion 
typically may be required to replace 30 percent of the water 
in human tissues (the approximate minimum established by 
Audrey Smith back in the 1950s). 
As I understand it, CI does not use a closed circuit. A 
mortician performs blood washout with 15 liters of Ringer's 
solution, then passes approximately 15 liters of 75 percent 
(v/v) glycerol through the patient in a simple one-shot 
procedure. The venous effluent is not recirculated. 
Let us assume that this open-circuit perfusion lasts no more 
than 1 hour (probably less). I believe that CI does not 
measure the venous concentration of perfusate as it flows out 
of the patient; therefore, no one knows what is happening in 
the body. But bearing in mind Mike Perry's calculations cited 
above, personally I would guess that the open-circuit system 
is sufficient to replace no more than 10 percent of water in 
the tissues overall. By comparison, in recent cases processed 
by BioPreservation, about 50 percent of water in the tissues, 
by volume, was replaced. 
As a result, while cells near capillaries in CI patients may 
be destroyed by high concentrations of glycerol, cells beyond 
this zone should still contain ample water to form large, 
destructive ice crystals during slow freezing. Therefore, the 
CI protocol appears to give us the worst of both worlds: high 
cryoprotectant toxicity in some cells, and major ice damage 
in others. 
     3. Damage Permitted by Inadequate Equipment. 
I believe that CI's mortician typically uses an embalming 
pump or a simple roller pump. In the case of an embalming 
pump, I believe it can create pressure spikes that rupture 
capillaries. Also, excessive pressure may contribute to 
edema. I believe, however, that CI never attempts to measure 
mean arterial pressure, and does not take the basic 
precaution of drilling a burr hole in the cranium, allowing 
noninvasive observation of the surface of the brain. A burr 
hole would also provide visual confirmation of blood washout, 
especially if inexpensive, non-toxic dyes are added to the 
perfusate. A set of bits to drill a burr hole would cost less 
than $200 and could be used with a simple hand-brace, 
available in hardware stores. 
If CI were willing to spend just a little more money (and 
with more than $1 million in the bank, surely it could afford 
to do so), a fiber optic probe could be used for realtime 
observation of brain capillaries during perfusion, enabling 
better verification of blood washout. If CI has made a policy 
decision not to bother with these monitoring procedures, 
which are cheap and easily implemented, I'd like to know why. 
     4. Claims of Independent Verification. 
For several years now, Bob, I think you have been claiming 
that the Russian cryobiologist Yuri Pichugin has verified 
your procedures. But in Pichugin's report, he describes using 
a series of stepped concentrations of glycerol, presumably 
because his training taught him that this was essential in 
order to avoid massive cell damage. 
As I understand it, CI does _not_ use this same procedure. 
Therefore, how can you claim that Pichugin verified your 
protocol, if his was completely different? 
Even using stepped increases in concentration, the electron 
micrographs that Pichugin produced showed severe injury, in 
the opinion of one of the world's leading cryobiologists who 
inspected the pictures. The micrographs also were evaluated 
by neurologists who found that the damage was so severe, they 
couldn't tell what kind of neurological tissue they were 
looking at. In view of this, how can you claim that CI's 
even _harsher_ treatment produces acceptable results? 
     5. Conclusions. 
My comments should not be interpreted as criticism of 
morticians who conduct CI's procedures. If a mortician is 
properly instructed, s/he may be able to do a competent job 
of blood washout and cryoprotective perfusion. However, so 
far as we can determine, CI does not give elaborate 
instructions to its morticians. 
I suspect that CI's members are unworried by deficiencies in 
its cryoprotective protocol because they share Bob's faith 
that scientists in the future will fix everything for us, no 
matter how bad the damage is. But since we have no guarantee 
that major damage will be reversible, and since we can reduce 
it by applying well-known principles of cryobiology at a very 
moderate cost, I cannot understand why CI doesn't take steps 
in this direction. 
Finally I find it impossible to understand Bob's suggestion 
that CI's protocol can produce results as good as those 
attained elsewhere using more elaborate procedures. This is 
very hard to believe, if the information that I have 
presented here is correct. 
     Charles Platt 
     President, CryoCare Foundation 

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