Total plasma exchange
What is total plasma exchange?
Total plasma exchange, also called therapeutic plasma exchange, is a hospital procedure that removes a person's plasma and replaces it with albumin, a blood protein, sometimes with immune globulin. It is an established treatment for some immune and nerve diseases. Some longevity clinics now offer it to lower biological age, which remains unproven.
Listed here because well-known people have tried it on themselves. Trying something is not recommending it; each entry says whether the person tells others to do it.
Who has tried it
Tried by 1 person we can source: 1 testing.
Testing
Bryan JohnsonEntrepreneur, founder of BlueprintBlueprint (Bryan Johnson)
Started Oct 2024 · Does not recommend it to others
Has his plasma replaced with albumin and IVIG on a biweekly schedule to test it as a rejuvenation therapy, and says it shows measurable effects.
“my team and I aim to figure out what works best when it comes to the use of TPE as a rejuvenation and longevity therapy”
Decrypt, Bryan Johnson ends blood infusions from son, opts for plasma instead (January 2025) · Status checked October 31, 2026 · Suggest a correction
What the evidence shows
The strongest human evidence is in a disease, not in aging. In the AMBAR trial, 347 people with mild to moderate Alzheimer's disease were randomized to plasma exchange with albumin or a sham procedure for 14 months. The treated groups lost less daily function, with a trend on memory and thinking; the effect showed in moderate disease but not mild disease [1]. The trial was run with Grifols, a plasma products company.
For aging itself, the evidence is small and relies on blood markers. In a 2025 trial of 42 healthy adults over 50, plasma exchange, especially every two weeks with immune globulin, moved 15 epigenetic clocks younger compared with placebo [2]. Several authors have ties to a company that sells the procedure. An earlier small study reported a younger blood protein profile after rounds of plasma exchange [3]. A Czech trial of a different procedure, plasma removal without replacement, found no rejuvenation and some clocks reading older [4].
In old mice, replacing half the plasma with saline and albumin improved muscle repair and liver and brain markers [5]. No study has shown that plasma exchange extends life, prevents disease or improves how healthy people feel or function. Epigenetic clocks are not proven stand-ins for those outcomes.
Safety
- Plasma exchange is an established treatment for specific diseases, graded disease by disease by the American Society for Apheresis. Using it to slow aging is not an approved use.
- Common side effects include low blood pressure, dizziness, and tingling or cramps from the citrate used to stop clotting, which lowers calcium. Catheters can bleed or become infected.
- It removes clotting factors, antibodies and some medicines along with old plasma, which can raise bleeding and infection risk for a time and change drug levels.
- Adding immune globulin (IVIG) brings its own risks, such as allergic reactions, headaches and blood clots.
- People with heart disease, low blood pressure, bleeding disorders or poor veins need a specialist's assessment first. Repeated sessions are costly.
Common questions
Does Bryan Johnson do total plasma exchange?
Yes. Since October 2024 he has had his plasma replaced with albumin and immune globulin every two weeks as a rejuvenation test, and says it shows measurable effects. He treats it as an experiment.
Does plasma exchange reverse aging?
Is total plasma exchange the same as young plasma?
No. Plasma exchange replaces your plasma with albumin, not with a young donor's plasma. In old mice, diluting plasma with saline and albumin was enough to improve several tissues [5].
Does plasma exchange help Alzheimer's disease?
In the AMBAR trial, people with moderate Alzheimer's disease who had plasma exchange declined less over 14 months than those given a sham procedure, while people with mild disease did not differ [1]. It is not an approved Alzheimer's treatment.
Sources
- 1.Boada M, López OL, Olazarán J, et al. A randomized, controlled clinical trial of plasma exchange with albumin replacement for Alzheimer's disease: Primary results of the AMBAR Study. Alzheimers Dement, 2020. doi:10.1002/alz.12137
- 2.Fuentealba M, Kiprov D, Schneider K, et al. Multi-Omics Analysis Reveals Biomarkers That Contribute to Biological Age Rejuvenation in Response to Single-Blinded Randomized Placebo-Controlled Therapeutic Plasma Exchange. Aging Cell, 2025. doi:10.1111/acel.70103
- 3.Kim D, Kiprov DD, Luellen C, et al. Old plasma dilution reduces human biological age: a clinical study. Geroscience, 2022. doi:10.1007/s11357-022-00645-w
- 4.Borsky P, Holmannova D, Parova H, et al. Human clinical trial of plasmapheresis effects on biomarkers of aging (efficacy and safety trial). Sci Rep, 2025. doi:10.1038/s41598-025-05396-0
- 5.Mehdipour M, Skinner C, Wong N, et al. Rejuvenation of three germ layers tissues by exchanging old blood plasma with saline-albumin. Aging (Albany NY), 2020. doi:10.18632/aging.103418
- 6.Connelly-Smith L, Alquist CR, Aqui NA, et al. Guidelines on the Use of Therapeutic Apheresis in Clinical Practice - Evidence-Based Approach from the Writing Committee of the American Society for Apheresis: The Ninth Special Issue. J Clin Apher, 2023. doi:10.1002/jca.22043