Case Summary:
This report details the case of Patient 1 treated by the Tomorrow Biostasis medical team in 2023, who experienced cardiopulmonary arrest and was transferred to the team 13 hours later. Upon receiving the patient, stabilization procedures like cooling and surgical cardiovascular access were initiated for cryoprotectant perfusion, gradually increasing to a maximum 70% w/v concentration. Temperature, pressure, and refractive index data was collected throughout, and a CT brain scan at dry ice temperature was obtained prior to further cooldown and long-term storage. CT analysis revealed around 43% of target cryoprotectant levels were achieved in the brain, likely impacted by extended ischemic time before transfer and pre-existing injuries. Several technical issues were identified, with procedural improvements and equipment redesigns planned as mitigations. While not achieving full targeted cryoprotection, this early case provides valuable data for Tomorrow Biostasis to optimize techniques moving forward

Case Summary:
This report covers the case of Patient 2, whose brain was fixed in formalin by the hospital medical team after passing away before being transferred to Tomorrow Biostasis. The patient's fixed brain underwent preliminary procedures at Tomorrow's facility, including an initial CT scan and immersion in gradually increasing concentrations of a cryoprotectant solution at 4°C to allow diffusion into the brain tissue over several weeks. The concentrations used were 5% w/v for 8 weeks, 10% w/v for 5 weeks, 30% w/v for 11 weeks, with 70% w/v ongoing at the time of this report. CT scans are regularly performed to monitor changes in brain density in Hounsfield units (HU), aiming for a target density of 190 HU at 4°C which indicates full cryoprotectant perfusion. Once target concentration is achieved, the brain will undergo cooldown to cryogenic temperatures for long-term storage. A minor issue with leakage in the immersion vessel was mitigated by replacement. Further results, CT analysis, and discussion will be included in Tomorrow Biostasis' full published report upon completion.

Case Summary:
This report details the procedures performed by the Tomorrow Biostasis team on Patient 3, who went into cardiopulmonary arrest around 3 hours prior to legal death being pronounced. Stabilization measures like cooling and medications were initiated promptly after receiving the patient. At the facility, surgical procedures accessed the cardiovascular system for washout and cryoprotectant perfusion in gradually increasing concentrations from 5% to the maximum 70% w/v target. Temperature, pressure, refractive index and other data was continuously monitored and recorded. Once terminal refractive index values were reached, controlled cooldown was performed including a CT brain scan during this process with calibration samples. The CT analysis showed excellent, uniform cryoprotectant perfusion throughout essentially the complete brain tissue. A few technical issues were documented like SSCD pump malfunction and challenges with intubation, along with their mitigations. Overall, the results represent a highly successful case achieving comprehensive brain cryoprotection according to the metrics used. Additional quality metrics may need to be developed since the existing CT-based one was optimally achieved.

Case Summary:
This report outlines the procedures carried out by the Tomorrow Biostasis team on Patient 4, who went into cardiopulmonary arrest around 3 hours prior to legal death being pronounced. After receiving the patient, stabilization measures including cooling, medications, intubation and surgical peritoneal lavage were initiated. At the facility, surgical access was obtained for washout solution and cryoprotectant perfusion up to the 70% w/v target concentration, monitoring temperature, pressure, and refractive index data. Once terminal refractive index values were reached, controlled cooldown was performed including a CT brain scan, followed by gradual cooldown to cryogenic temperatures for long-term storage. The CT analysis showed excellent, uniform near-complete brain cryoprotectant perfusion. A few minor technical issues were documented like brief disruption of mechanical compression and challenges with refractive index measurement, along with their mitigations. As with the previous case, the results represent very successful comprehensive brain cryoprotection that warrants developing additional quality metrics beyond the CT-based one which was optimally achieved. Overall protocol refinements and new metric development are ongoing processes.