The practice of “perfusion” in cryonics has mostly been incompetent: and by that I mean riddled with iatrogenic events, such pumping air, having aortic root cannulae “pop out” during perfusion, subjecting a patient to a wall water leak through a disposable heat exchanger, and on and on. More recently, competent board certified percussionists are being used in the absence of a competent team leader – the equivalent of the perfusionist functioning in the complete absence of a cardiothoracic surgeon, or an appropriately trained interventional cardiologist. They are, in effect, presented with a cryonics patient and told to “perfuse him.” Missing from that equation are a careful pre-perfusion work-up and a thorough understanding of the possible complications or contraindications that might arise from the patient’s pre-cardiac arrest medical condition. Ditto any deep understanding of the physiology of perfusion under conditions of ultraprofound asanguineous hypothermia, let alone when cryoprotectants are present.

Interestingly, one of the things which outraged Ms. Maxim was my questioning her recommendations for the perfusion of cryonics patients. One of my concerns, which was unheeded, was the damaging effect of ethylene glycol and especially dimethylsulfoxide (DMSO) on polycarbonate, buna-N and PVC components in the circuit. Recently, I read a case account from the Cryonics Institute, who was following Ms. Maxim’s advice and reusing their centrifugal pump heads, that they experienced pump head failure during a case which they attributed to DMSO-induced degradation.

There are many, many such factors unique to the practice of perfusion in cryonics. This is pretty much what should be expected, since the conditions are so radically different than those seen in the clinic (i.e., long ischemic times, depth and duration of hypothermia, effects of cryoprotectant agents, etc.). My comments were not well received and Ms. Maxim seemed fixated on cryonics as medical fraud. Bad practice? There’s certainly plenty of that to go around, but fraud? Well, that requires that the people paying for the bad practice are being deliberately deceived. In fact, they know quite well what he state of affairs is – they simply don’t care – or don’t care enough to change it. — Mike Darwin