Towards this we proposed and tested a cell based ODE

Towards this, we proposed and tested a cell-based ODE/PDE hybrid model of CPA equilibration in hamster islets of Langerhans [10], and work incorporating the damage modeling theory presented in this manuscript into that model is underway. In the future, more detailed cell-based models can be implemented using off-the-shelf computer packages such as PhysiCell [30]. Here we present only the equilibration to high concentrations of CPA, not equilibration from high concentrations of CPA for several reasons. First, we require further testing to determine the appropriate critical concentration for each tissue type. This critical concentration in turn will dictate the final CPA concentration distribution in the tissue, and will be defined by the optimal protocol plus the pre-quenching and post-warming handling times that will allow for further CPA concentration distribution throughout the tissues. Second, we have previously shown that the CPA equilibration to high concentrations is the critical part when it comes to toxicity accumulation [9]. This is in part because we exposed porcn to concentrations that maximized their intracellular water volume, effectively diluting the intracellular CPA concentration and thus the integrand of eq. (1). Finally, to remove CPA, we previously used media containing only non-permeating solutes. This facilitates larger CPA gradients (transmembrane in our previous cases) and thus faster equilibration protocols. However, as discussed above, this feature was not included in our computational model for this study and is a subject of our present research. Finally, we note here that a number of decisions were arbitrary. For example, our goal concentration CD was informed by phenomenological arguments. A better approach would be to establish actual measured critical concentrations as a spatial function inside the tissue given the cooling rate for the container. Our approach is equally valid whether CD is set to 34% or 45%. In fact, it should have much higher payoffs in the prediction of reduced toxicity protocols when higher concentrations are desired. However, it is interesting to note that if CD is in fact the correct value for this freezing rate, then our modeling indicates that for both myometrium and fibroid tissue, the standard protocol is overlong. This added unnecessary exposure at high concentrations would add dramatically to the accumulated toxicity, especially at the exterior region of the tissues. On the other hand for the skin tissue, Fig. 3 shows that the standard protocol (with total duration 60 min) would have ended too soon, and the tissue would have not been sufficiently equilibrated with CPA. In this case, the center of the tissue would have insufficient CPA to avoid significant ice formation. Therefore, even in the absence of toxicity cost function minimization, modeling CPA transport to develop equilibration protocols is essential to ensure appropriate tissue equilibration has taken place.
Conclusions