Reversible vs Irreversible Ischemic Cell Injury

This simulator renders a field of cells as a 3D tissue block and drives each one through a simplified but physiologically grounded ATP budget: ischemia shuts off oxidative phosphorylation, ATP decays, the Na⁺/K⁺ pump fails, and osmotic water influx swells the cell — classic reversible cellular injury. Each cell also accumulates an injury clock while its ATP stays critically low; cross that threshold and the mitochondrial permeability transition pore opens, marking the cell irreversibly injured no matter what happens next. Reperfusion — restoring blood flow mid-simulation — fully rescues any cell still on the reversible side of that line, while cells that already crossed it continue toward necrosis regardless, visualizing why the clinical treatment window in ischemic injury is a race against a real, cell-by-cell point of no return.