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August 1, 2008

Recent Cryopreservation

One of our members, A-1212, suffered cardiac arrest in Hawaii last week. The gentleman had suffered a fall and been released from the hospital, and then he fell a second time. On this admission to the hospital, he was diagnosed with pneumonia. Treatment with antibiotics was going well, but his heart stopped suddenly. We were not notified until between 15 and 30 minutes after pronouncement. Negotiations with the hospital for the application of our emergency protocol did not go quickly or smoothly. Ultimately, they did agree to begin surface cooling and administered an intranasal dose of heparin (They had removed all IV lines before we were called and were unwilling to place a new one.) before releasing him to the funeral home.

Initial negotiations with funeral homes in Hawaii were also difficult, as none were willing to commit to rapid transit. We went through three separate facilities to find one that would carry out our instructions. With all the delays, it was a full 42 hours after pronouncement that the patient arrived at Alcor, which proved faster than the original 3-4 day estimates.

The decision was made to attempt cryoprotection. We know from previous cases that vitrification is achievable after 30 hours and application of the medication protocol and surface cooling, and we decided to see if it was possible to improve our understanding of the limits to vitrification. It was quickly established that 42 hours with little surface cooling and virtually no meds, vitrification was not possible. We then straight-froze the brain.

During this case, there was much discussion of whether or not to remove the brain, chemically fix it and do a diffusion cryoprotection. Because insufficient data exists to tell us whether this would have resulted in superior structural preservation, we chose to use our standard protocol.

This patient received our 5th cryopreservation of the year, and he is our 83rd patient.

May 19, 2008

Two Recent Cryopreservations

In the past ten weeks, we’ve deployed six standby operations and have performed three stabilizations and cryopreservations (including A-2340 discussed in a previous entry). Of the two most recent cases one patient required two standbys and the other three in advance of cardiac arrest. They were performed on opposite coasts, with the first patient coming from California and the second from Florida. Both patients were successfully stabilized, transported, cryoprotected and cooled.

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March 31, 2008

Alcor Cryopreserves 80th Patient

Over the weekend, Alcor completed an unusual non-confidential, last-minute case: the cryopreservation of Rose Selkovitch, A-2340. Rose was nearly 102 years old at the time of her cryopreservation.

Because of the last-minute nature of this case, Rose passed away as the standby team was still en route to her Escondido, California location on 29 March 2008. The transport vehicle had been deployed from Arizona with two team members and a member of the southern California team drove down. Due to advance negotiations, a dose of heparin was administered by hospice personnel after her pronouncement at approximately 20:30, chest compressions performed to circulate, and she was packed in ice upon pronouncement of legal death. By the time, the standby team and the funeral director were on-site, the cannulations completed and the washout ready to begin, Rose’s temperature was at 6 degrees C. An equipment problem and concerns about pumping the warmer blood from her chest cavity into her brain (which would warm it up significantly) contributed to a decision to not do a washout in California, but instead begin transport to Arizona for cryoprotection.

Transit paperwork was received in a timely fashion, and the transport concluded without incident. The surgery revealed that Rose had extremely large carotid arteries, and our surgeon suspected there was an aneurysm deeper in the carotid on the right side. Nevertheless, the blood washout went extremely well, resulting in a hematocrit reading that was undetectable. Cryoprotection began at 19:34 on 30 March and concluded at 00:33. Target concentrations of cryoprotectant were achieved in the brain, and first-stage cooling was begun shortly thereafter.

Support from hospice personnel and the local funeral home were instrumental in this case going well. Being just five weeks shy of her 102nd birthday makes Rose the oldest cryopreserved patient at Alcor today. She is our 80th patient.