X-Message-Number: 11238
Date: Mon, 8 Feb 1999 12:46:12 -0500 (EST)
From: Charles Platt <>
Subject: 21st Century Medicine Seminar Summary: Part 3

     The following text is the third of three parts of a 
summary of the seminar sponsored by 21st Century Medicine in 
Ontario, California, on November 8th last year. This seminar 
presented preliminary results of research that promises to 
eliminate damage in cryopreserved organs caused by ice, 
toxicity, and rewarming. 
     Originally I had hoped to circulate my summary of this 
exciting research last December. I was delayed by problems 
transcribing the tape, and by conflicting obligations. I 
regret the delay but am now able to offer my summary, 
accompanied by excellent reproductions of brain electron 
micrographs, in a 16-page leaflet. Members of CryoCare 
Foundation will receive this publication automatically; 
anyone else can receive a copy free by sending a self-
addressed 9" x 12" envelope to Charles Platt, P.O.Box M, 
Jerome, AZ 86331. 
     Alcor members will find a version of this text, with 
lower-resolution photos, in the current issue of Cryonics 
magazine. An abridged version, with fewer photographs, is 
scheduled to appear in The Immortalist. 
     The complete seminar is available on a set of five video 
tapes for $50. Individual tapes are also available for $15 
each. Call toll-free 877-277-0322 or send a check or money 
order payable to Life Extension Foundation, Box 229120 Dept. 
21MED, Hollywood, FL 33022. 
     Part Three 
     Questions and Answers 
     After the formal presentations, Mike Darwin, Steve 
Harris, MD, Gregory Fahy, and Brian Wowk received questions 
from the audience. 
     Linda Chamberlain of Alcor Foundation asked about the 
price and availability of perfluorocarbon compounds. Mike 
Darwin replied that it had been difficult to obtain them, but 
recently he located a new supplier with a large stock. The 
compounds may cost between $20 and $35 per pound, but in a 
perfluorocarbon perfusion circuit most of the chemicals can 
be retained and reused. 
     Another questioner asked exactly how antifreeze proteins 
prevent ice from forming. Brian Wowk explained that they 
"form a kind of antibody-antigen match onto the a-axis face 
of ice. They coat it and prevent growth in that direction." 
     Fred Chamberlain of Alcor wondered what happens if you 
increase the concentration of ice blockers or methoxylated 
compounds, and whether they will be prohibitively expensive. 
     Brian Wowk answered that a higher concentration of 
methoxylated compounds will tend to dissolve cell membranes. 
"We're cruising on the edge of that," he said. A problem with 
X1 is that it tends to increase viscosity of cryoprotectants. 
Overall, Wowk said he expects that the optimum concentration 
of X1 will be "a few percent." 
     Saul Kent said it was premature to talk about pricing, 
but Brian Wowk pointed out that anyone with a chemical 
catalogue could find methoxylated compounds available off-
the-shelf. "Technically the only thing to stop you from using 
them is infringement on our pending patent," he said. 
     As for ice blockers, "We could probably supply as much 
as you want at a reasonable price. . . . Chemical synthesis 
houses making this compound for us are not giving us anywhere 
near the kind of sticker shock that antifreeze protein 
synthesis gives us." 
     Another questioner asked how long we have to wait for 
viable suspended animation. Brian Wowk said it should be 
possible within ten years for the brain, but much sooner for 
kidneys, because this is the major focus of research. "If 
sufficient funds become available from people who are 
interested in the [brain] problem," he went on, "we could 
tackle the brain just like any other organ. 
     Mike Darwin agreed that "somebody has to fund the work 
on brains, and it isn't going to be the people funding the 
work on hearts or kidneys or livers," because that research 
has an obvious financial payoff, while brain preservation 
interests only cryonicists. Consequently, according to 
Darwin, "this audience and the people they represent are 
going to be the ones who pay for it, else it just isn't going 
to get done." 
     "To get to the point where a brain is successfully 
cryopreserved in every sense of the word is an enormously 
complicated and resource intensive process," Gregory Fahy 
commented. "We don't have the manpower to divert a lot of 
extra attention into those areas unless they are funded." He 
said he expects to discover "all kinds of adverse things that 
we have no clue exist right now, all kinds of things we 
haven't thought of, and we'll have to solve those problems. 
This will take a dedicated team working week in, week out, 
year in year out, relentlessly, until the problem is solved. 
We just don't have the assets for that now." 
     Another questioner asked how much it might cost. 
     "$10 million has been speculated," Brian Wowk answered, 
adding that this is a reasonable guess. He didn't think it 
would cost as much as $100 million, but he was sure it would 
cost more than $5 million. 
     The panel discussion broke up shortly after this, and 
many of the attendees visited the two laboratories where the 
research has been done. Some people complained that the 
presentations had been overly technical, while others 
wondered whether the owners of the new technology will make 
it available on an affordable basis. Saul Kent said 
subsequently that he intends to offer results of the research 
at a reasonable price to all cryonics organizations. 
Obviously 21st Century Medicine hopes to reap profits from 
applications outside cryonics, which is a minuscule market by 
     The prospects for human cryopreservation have never 
looked better. Prospects, however, don't turn into realities 
without an infusion of money and labor. 
     The new brain studies at 21st Century Medicine are 
immensely promising, but in the immediate future the company 
must pursue research that will generate revenue, and brain 
research is unlikely to fulfill this need. Therefore, if we 
want zero-damage, reversible brain cryopreservation, we can't 
count on outside investors to pay for it. We, as cryonicists, 
probably will have to pay for it ourselves. 
     Six years ago, I bought $10,000 of stock in 21st Century 
Medicine. This represented about one-quarter of my savings at 
that time. Some others also purchased stock, but the 
wealthiest people in cryonics showed only a token interest--
or no interest at all. Consequently, Bill Faloon and Saul 
Kent shouldered the primary burden. By my estimate, they have 
spent about $10 million so far. 
     I am constantly amazed by the reluctance of wealthy 
cryonicists to put money into research that could increase 
their own chances of survival. It seems grossly irresponsible 
to assume that others in the future will fix freezing damage 
for us, when there is no absolute guarantee it will be 
reparable, and we could be addressing the problem ourselves. 
     In the past, there was some doubt that investment in 
research would pay off. This doubt should be dispelled, now, 
by the evidence presented at the 21st Century Medicine 
seminar. Kent and Faloon have demonstrated that money really 
can buy remarkable progress within a short space of time, and 
almost certainly reversible cryopreservation can be ours if 
we really want it. 
     Within the next year we will see whether cryonicists are 
willing to acknowledge this fact--or whether "Let someone 
else deal with the problem" will continue as the dominant 
motto in cryonics, as it has for the past thirty years. 
     21st Century Medicine Team Led by Mike Darwin 
     Now Holds World Record for Survival of Ischemia 
     at Normal Body Temperature 
     For several years, Mike Darwin has been looking for new 
techniques to inhibit or treat brain damage that occurs after 
blood circulation stops suddenly, as in a heart attack. In 
his presentation at the 21st Century Medicine seminar, Darwin 
noted that sudden cardiac arrest is the leading cause of 
death in the United States, afflicting 540,000 people 
annually. He said that despite the advent of CPR and 
widespread deployment of paramedic teams, fewer than 1 
percent of cardiac patients survive without any brain damage 
if they suffer four to six minutes of cardiac arrest. 
     Any treatment that can improve these dismal statistics 
obviously would be extremely valuable in emergency medicine, 
and Darwin told his audience that the methods he has 
developed with his primary team, Steven B. Harris, MD, Sandra 
Russell, Joan O'Farrell, and Carlotta Pengelley, could save 
300,000 lives each year. 
     The research is important also to cryonicists, since we 
are concerned with preserving the brain with minimal damage 
in all phases of our procedures, including the first crucial 
minutes after legal death is pronounced. 
     Darwin and his team have been remarkably successful, 
routinely reviving dogs after 15 to 17 minutes of cardiac 
arrest at normal canine body temperature, under anesthesia. 
(These results should not be confused with those of previous 
dog experiments where much longer survival times were 
achieved with deep hypothermia.) 
     A major factor in the success of recent resuscitation 
research was Steve Harris's suggestion that ischemic injury 
can be viewed and treated as an inflammatory response, 
similar in some ways to the swelling and inflammation that 
occur after any localized injury. 
     Darwin reported that in eight separate experiments with 
dogs, three achieved excellent recovery after six weeks 
(showing no neurological deficit at all), three showed good 
results, and two did not survive. He claimed that these 
results have not been matched by any other laboratory. 
     Unfortunately the protocol is complicated. After blood 
flow is restored, multiple drugs must be delivered within 5 
to 15 seconds, while body temperature must be lowered by 
about 4 degrees Celsius within 3 to 5 minutes. How can this 
be achieved by paramedics working on human patients out in 
the field? 
     Darwin said that a computer-controlled system will be 
needed to deliver the drugs. The FDA has been reluctant to 
approve biomedical software, and also is generally opposed to 
multidrug cocktails. Consequently, the approach developed by 
Darwin and his team may be applied only outside of the United 
States, initially at least. 
     The challenge of rapid cooling seems severe. Darwin told 
the audience at the seminar that external cooling via a 
stirred ice-water bath typically requires about 80 minutes to 
lower body temperature by 5 degrees Celsius. This is far too 
slow, and requires about 300 pounds of ice and 200 pounds of 
water, making it impractical for use in the field. 
     However, Darwin said that the lungs can be used as a 
heat exchanger. Since all cardiac output flows through the 
lungs, which have a huge surface area of 70 square meters, 
they provide an excellent opportunity to draw heat out of the 
blood, which then cools the brain. 
     Cold air cannot remove heat rapidly enough, but a 
breathable liquid is effective and can be applied by 
intubating the patient, which is a standard emergency 
procedure. According to Darwin, experiments with dogs have 
proved that mixed-mode liquid ventilation using a 
perfluorocarbon at about 2 degrees Celsius can provide more 
than enough breathable oxygen while lowering body temperature 
by about four degrees in the first five minutes. An average 
cooling rate of 0.36 degrees Celsius per minute has been 
achieved, and dogs have recovered fully after their 
temperature has been reduced by as much as 10 degrees. 
     Since liquid ventilation is not only effective but could 
be deployed relatively easily in the field, it has a clear 
advantage over any other method of reducing temperature. It 
could be used to treat head injuries as well as ischemic 
injury caused by cardiac arrest, according to Darwin. 
     He said that inspection of lungs after liquid 
ventilation showed "some isolated areas of injury," 
particularly at the bottom part of the lungs, probably from 
contact with the very cold perfluorocarbon liquid. Still, the 
animals showed no sign of distress, and light and electron 
microscopy revealed no sign of structural damage in other 
areas of the lungs. 
     "If you can automate this process, any paramedic can do 
it," Darwin told his audience. He predicted that it could be 
"a potential profit center" that could save a lot of lives, 
and said he hopes to see clinical trials 2 to 3 years from 
     Although Darwin didn't mention the use of liquid 
ventilation in cryonics cases, obviously it would be 
extremely valuable and could be applied in the very near 

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