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Therapeutic Plasma Exchange for Health & Longevity

Created on 10/24/2026 – Quick Reference based on Evidence Review created using AI4L / Opus 5.5 – Audit

Therapeutic plasma exchange, a hospital procedure removing much of the blood's liquid part (plasma) and replacing it with a protein solution, is explored for slowing aging. Evidence is thin and conflicting: one company-funded trial suggested slower loss of daily function in moderate Alzheimer's disease, and biological-age tests in healthy adults moved both ways. Benefits in healthy people are unproven; short-term risks are modest but real. (Full Review)

Protocol

Buck–Circulate healthy-aging regimen
One plasma volume replaced with 5% albumin
Monthly for six sessions, or two sessions in one week monthly for three months; optionally with 2 g IVIG
Conboy–Kiprov dilution regimen
One plasma volume exchanged for 5% albumin
Followed by 2 g of 10% IVIG; repeated in roughly monthly rounds
AMBAR Alzheimer's regimen
Six weekly full exchanges
Then twelve monthly low-volume exchanges with 20–40 g albumin, with or without 10–20 g IVIG
Time to effect
Antibody-mediated disease
Four weeks
Faster recovery versus supportive care in Guillain–Barré syndrome
Alzheimer's disease
14 months
Functional differences emerged over 14 months
Biomarker shifts
One to three months
Appeared after about three sessions and faded later

Benefits

Contraindications
  • Active infection or active cancer
  • Symptomatic coronary artery disease, congestive heart failure, restrictive lung disease or asthma
  • Poor arm-vein access that would need a central catheter
  • Inability to pause ACE inhibitors for 24 hours before a session
  • Late-stage Alzheimer's disease
  • IgG below 6 g/L
    •
Key Interactions
  • Monoclonal antibodies (laboratory-made antibody drugs; e.g., rituximab): Caution
  • Anticoagulants and antiplatelets (anti-clotting drugs; e.g., warfarin, apixaban): Monitor
  • Antihypertensives and diuretics (blood pressure and fluid-removing drugs; e.g., amlodipine): Caution (theoretical)
  • IVIG and other infused biologics (protein-based drugs; e.g., antithymocyte globulin): Monitor (theoretical)
  • NSAIDs (nonsteroidal anti-inflammatory drugs; e.g., ibuprofen) and aspirin: Caution (theoretical)
  • Calcium-containing antacids (e.g., calcium carbonate): Beneficial interaction
  • Fish oil, vitamin E, ginkgo, high-dose curcumin: Caution (theoretical)
  • Blood pressure-lowering supplements (e.g., beetroot nitrate): Caution (theoretical)
  • Protein-bound or lipid-carried supplements (e.g., vitamin D): Monitor (theoretical)
  • Vaccinations: Caution (theoretical)
  • Blood or plasma donation: Avoid combining (theoretical for the combination)
  • Immunosuppressants and rapamycin (e.g., prednisone, sirolimus): Caution
    •

Risk & Side Effects

  • High:
  • Medium: Procedure-related reactions; vascular access complications; more serious adverse events when IVIG is added
    •
  • Low: Serious infection from antibody depletion; clotting factor depletion and bleeding; allergic and anaphylactoid reactions; transfusion-related lung injury with donor-plasma replacement; rare severe cardiopulmonary events and death; mineral, protein and homocysteine shifts with frequent plasma removal
    •
  • Speculative: Acceleration of epigenetic aging clocks; rebound of removed factors
    •

Monitoring

Marker Target Why
Immunoglobulin G (IgG) About 7–16 g/L Safety check: infection risk
Fibrinogen About 2–4 g/L Safety check: bleeding risk
PT and aPTT Not specified in the ER Clotting check paired with fibrinogen
Ionized calcium About 1.15–1.30 mmol/L Safety check: citrate reactions
Complete blood count (platelets, hemoglobin) Platelets about 150–400 ×10⁹/L Safety check: bleeding risk
Albumin and total protein Albumin about 35–50 g/L Safety check: inadequate replacement or recovery
Homocysteine About 5–15 µmol/L Safety check: rose with frequent plasma removal
Folate and vitamin B12 Not specified in the ER Paired with homocysteine
Kidney and liver panels Not specified in the ER Baseline screening
Epigenetic clock (e.g., GrimAge) No established target; track change from own baseline Marker the intervention is expected to change
PFAS panel (e.g., PFOS) No established target; track change from own baseline Marker the intervention is expected to change

Cadence: Baseline before the first session; IgG, fibrinogen, calcium and blood count before every session (for example monthly); clotting tests if anticoagulants are used; epigenetic clocks at baseline, after the third session and 3–6 months after the course ends; PFAS or homocysteine every 3–6 months during repeated courses

Qualitative Assessment

  • Energy levels and post-session fatigue
  • Lightheadedness, tingling or cramps during sessions
  • Bruising or bleeding at access sites
  • Frequency of infections between courses
  • Cognitive clarity and ease of daily tasks
Not medical advice. Educational distillation of a single evidence review. Confirm any decision with a qualified clinician, especially in the presence of prescription drugs or chronic conditions.