Lowering the Cost / Improving Access for Therapeutic Plasma Exchange (Plasmapheresis)

IV Fluids and Solutions Guide & Cheat Sheet

  • 0.9% NaCl (Normal Saline Solution, NSS)
  • Dextrose 5% in Water (D5W)
  • Lactated Ringer’s 5% Dextrose in Water (D5LRS)
  • Ringer’s Solution.
  • Nursing Considerations for Isotonic IV Solutions.
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We have a skunk works, being created right before your eyes!

There’s even an easier way to do it:

  1. Donate plasma.
  2. Schedule to get a vitamins/NAD cocktail on the same day (in a different place)
  3. Ask if they could add some albumin to their cocktail :blush: ( bring your own albumin)

The beauty of it is that you don’t need to have any equipment at home and you don’t have to learn how to poke your vein.

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Appreciate the math. In my case, as a 175 pound male, they took about 890ml of plasma per donation, which I estimated to be 29% of my total plasma. I even tried donating Monday evening and Wednesday morning to shorten the window between donations. One way around the 5 day window is to try to do it at 2 different companies without telling them. However, they do visual arm checks for bruising and if discovered you will be permanently banned. You would also need to live in an urban area that had 2 providers.

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Puzzling. Looks like you took the donation route to its limits. Maybe the bad stuff in the plasma regenerates so rapidly that 70% dilution (I think that was Dr. Kiprov’s number) can’t be reached that way. Or, if it can, the shock of quick dilution is what’s needed to tip the balance. Or, like everything else biological, donations didn’t work for you but would for someone else.

Just one more interesting point… if anyone is potentially interested in setting up their home longevity Clinic or longevity biotech laboratory similar to what Bryan Johnson has done (but at 1/1000 the cost), this may be the best year to do it (compared to anytime in the past decade or more).

The simple reason is that the biotech investment climate has changed dramatically for the worse in the past year and so a lot of biotech companies are going to be going out of business. What this means is there is going to be a flood of inexpensive lab and biotech / health equipment coming up for sale as liquidators sell off these assets from defunct biotech / healthcare companies. If you live close to any of the major biotech hubs like San Diego, San Francisco or Boston, it seems there may be some particularly good opportunities and a large volume and variety of things being sold.

Just so people understand what is going on better… here is a summary of the current state of the market (its ugly out there, though thankfully not as bad in longevity biotech):

Related reading:

and

And, From Bloomberg:

With VC Funding Drying Up, Biotechs Are on a Quest for Cash

After years of abundant funding, today’s scarce capital is prompting layoffs and deals with Big Pharma.
Full story: https://archive.ph/rpHLU#selection-3467.0-3473.104

So, there is a lot more supply than there is demand right now for biotech-oriented equipment (and that probably also is true for healthcare-related startup companies and related types of equipment). So… a great time to be buying lightly used biotech and medical stuff.

I’ve been looking around a bit at the online auction websites for lab / medical equipment and finding the prices are fantastic. Of course… its a little more complex than just ordering off amazon as you have to know what you are buying, want to be close to the auction sites’ physical location so that you can go and inspect the equipment, and you need to search for, find, and read up on the product’s online operators manuals, etc. so you know what to look for in terms of equipment functionality…

But - just to give you an idea of the deals that can be found…

@Joseph has mentioned he’s found $8,000 equipment (list price) that he’s been able to pick up for $13.00 US. (just to save you the math, thats about 99.9% off… a pretty good sales price :wink:

I’ve looked at some things like this ultra-low temperature freezer (i.e. -80º C) that would make it easy to store medications for many years (as well as your icecream :wink: ). Normally these things are about $8,000 when purchased new and right now bidding on this one is $600.

And below, this nicely designed and compact bench-mounted fume hood system which would be a great thing for anyone making their own drug formulations (as Mac did to make his rapamycin injection formulation - to make sure they are created in a sterile environment).

One is available and seems likely to be able to be purchased for a low price - nobody has even bid on it yet, so perhaps $100US? (and typically retails for $5K+ US )

Retail Price: 4,500 British Pounds: https://www.thelabstore.co.uk/lab-bubble-bub-sty-blk-safety-bubble-bench-mounted-fume-hood-system-black-base-supplied-with-hepa-and-carbon-filtration-air-flow-alarm-and-lamp.html

Anyway - just wanted to get people thinking about these options, because the deals seem to be out there more now, than ever. Let us know if you find anything interesting out there that may not be for you, but due to location, etc. might be a good fit for someone else here…

2023 and 2024 look like they could be banner years for biohackers who want to invest a bit in their home labs / clinics!

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This is what I purchased;

https://www.fishersci.com/shop/products/echotherm-in30-in40-series-benchtop-chilling-heating-incubators/1168036

I was incorrect on the retail cost.

Retail cost $11,980 plus sales tax plus shipping.

Yes, I paid $13.00{I was the only bidder] and have to pick the unit up.

Also picked up a few other items.

No one wants to create/build a skunk works?

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It seems that plasmapheresis (Therapeutic Plasma Exchange/TPE) is something that they’ve also done in dogs… it would be extremely interesting to see a clinical study where they did weekly TPE on dogs over months, and see the impact on biological age, functional abilities, etc… perhaps a great fit for the Dog Aging Project.

One of the key cost components in a plasmapheresis / TPE service is apparently the pricing that the equipment providers charge for the “consumables”, e.g. the plastic tubing and filters used in the equipment. This is obviously where the companies make extremely high margins… they frequently charge in the range of $2,000 to $2600 for this customized set of single-use sterile tubes and filters.

I have to believe that the gross margins on this type of tubing set is in excess of 98%. This is a “razors / razorblades” type of business taken to the extreme. They lock you into their product by selling you the device, but then for every patient and every use they generate extraordinary profits. From the business perspective it looks like an amazingly profitable business, but from the user perspective it drives up the cost to unacceptable levels.

So - how could people get around this?

One option is perhaps to purchase these products from third world countries (e.g. India, etc.) where they have to price the products lower because of the lower incomes/ability to pay in these countries.

I also wonder if there are companies (e.g. chinese or Indian companies) that may have started developing knockoffs of these types of products, and selling them at prices under $100.

Another option is outlined in this paper attached below:

The COBE Spectra Apheresis System by Terumo performs plateletpheresis on horses. Our clients would like to use this method to efficiently extract equine platelets for their research. They have developed a novel equine platelet therapy that has been shown to be effective in mice. However, a one time use tubing kit from Terumo can cost up to $2600. The team has been tasked with bringing this cost down to $100 per use. This can be done in one of three ways: create a simplified tubing design, create a new sterilization protocol for current tubing, or to remake current tubing with new material. The create a simplified tubing design won our design matrix, so this option was carried out. A basic tubing skeleton ($56.03) was made of sterilizable materials (PVC, polypropylene connectors), harvesting pressure sensors, air traps, and centrifuge components from the original tubing set. This was demonstrated to interface with the COBE Spectra Apheresis System without leaking. An additional safety component to remove air was partially manufactured but could not be completed due to late material shipments.

See full report below (I wonder how this project has developed as this paper was completed two years ago):

Cheaper Apheresis Tubing Final Design Report (3).pdf (1.7 MB)

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As can be seen from the following example of a used plamapheresis machine, the prices drop off very quickly for used equipment. Part of this must be because of the currently high prices for the "consumables’.

In this case below the price of the used plasmapheresis machine (which sold new for $30K to $50K) is only 1,900 Euros (asking price)… less than the price of the set of plastic tubes that the company sells for each plasmapheresis treatment…

This does seem like an opportunity for biohackers as any commercial organization won’t balk at the new prices of the equipment, and have to purchase the “consumables” through the standard medical equipment dealers in their country (but the biohackers can buy from anywhere, just as they do with medications).

Obviously this is all pretty technical and medically complex equipment and processes - so I understand why not a huge number of people seem to be jumping into the discussion with an interest in doing this at home.

But, I’m starting to envision how the “barriers to entry” to this type of thing might be overcome in the following manner:

In many cities around the world there are, (or can be) biohacking centers or interest groups (meetups). Many of these people are more technical in nature… ideally you’d create a small group with people who have backgrounds in medical services (i.e. medical doctors & nurses, hardware and software engineers, and biologists… and of course the rest of us who are enthusiasts and interested in learning new things…_)

From these biohacking groups we should be able to find other people that would be interested in creating a subgroup… in the bay area we call these “SIGs”… or, special interest groups. In this case focused on personal plasmapheresis. Think of it as a “plasmapheresis club”.

There are likely biohacker groups in your area (if not, then start one). Examples in the San Francisco Bay Area of good biohacking groups are:

Each plasmapheresis machine (if people are doing it one every week or two or three) seems like it would support somewhere between 14 and 28 people, assuming not everyone would do it every week - and perhaps doing an average of one plasmapheresis treatment every 2 to 4 weeks.

The support / operation seems like it could likely be a shared learning experience for everyone, with the process ultimately getting well-documented (and of course, the video of the process shared on youtube).

The cost could be shared by all the users - so the cost of the equipment becomes minimal (divided by 28 people, and perhaps “membership” price in this little plasmapheresis club is targeted $1,000 a year or something and hire a professional equipment technician to regularly service the machine and make sure its operating correctly).

And bulk orders of the “consumables” could be imported by individuals or groups from contacts in other lower cost countries. See this example:

https://dir.indiamart.com/search.mp?ss=Apheresis&prdsrc=1&mcatid=23488&catid=567&res=RC2

What do people think?

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And sources for used lab / clinical equipment (please add more sources that you find):

https://www.machinio.com/?search=apheresis

https://www.edispositions.com/auctions/

https://www.publicsurplus.com/sms/browse/cataucs?catid=2301

Ebay Medical auctions:

https://www.ebay.com/b/Healthcare-Lab-Dental/11815/bn_1851782

In the UK:

Joseph, can you tell me what you might be using something like this for? Just curious. Its not obvious the benefits of a device like this (though at $13 I could probably find some :smile:

My first thought is to use it to grow/ferment milk based yogurt.

Very accurate temperature control, semi-automatic{after programming] cycle heat to cooling. Better than a temperature control water bath.

I know this is eccentric.

But for $13.00.

A 10k yogurt maker.

Thinking outside the box.

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Nice! You got a great deal, but I don’t know why they keep talking up the efficiency of Peltier. It’s not as efficient as compressors. It’s more bulletproof and easier to control precisely.

It sounds very interesting. I would love to have such equipment at home and use it on myself. However, it could become a serious liability matter, especially if a medical procedure (or even directions how to do it) is offered to public (group participants) by a non-licensed provider. Each state probably has its own regulations. I don’t think that any medical professional would participate in such arrangement (they could just open a clinic and offer such service, like Irina and Mike C.). It’s one thing to do it in a privacy of one’s home, and a totally different thing to offer it to a group of people. I envision that very soon there will be many clinics like that in every state and the price will go down a lot. It’s just the beginning. Just my 2 cents. Am I too cautious?

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I have supervised therapeutic plasma exchange for many years and am currently a medical director for Biolife
You need to be aware of all the regulations that govern safety and testing needs to do TPE
Donors need screening labs repeatedly and all the inspections need to be done to prevent disasters and gain continued certification and safety
That’s why it’s so expensive
and needs meticulous care
Any corner cutting could prove fatal
Let’s keep it real people
You can’t do this in your garage with used equipment

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Hi Jeffrey, welcome to the forums and thanks for posting. I appreciate the input of professionals on these issues.

On the donor side, which I believe you are on right now, I understand that there are an have to be many regulations and testing.

But if we keep the focus initially on the plasmapheresis type of approach using Albumin 5% for dilution-oriented TPE, it would seem to be much simpler (I’m not advocating any biohackers create their own donation system right now). It would seem that purchasing regularly prescribed albumin (the same solutions I believe that the TPE centers use) - its a much simpler therapy, is it not?

I think your point is that the donation / processing done to get fresh / frozen plasma (the “young blood” approach) is quite complex and regulated, and I agree with that.

But, if you have good equipment that has been tested and validated as functioning well. And if you have a well documented process / procedure with educated and well-read people who have experience with venepuncture processes, that its possible to do this process. I mean people are doing it: https://www.lifespan.io/news/biohackers-perform-first-plasma-dilution-experiment-on-humans/

Your point, I think, is this isn’t for everyone - and I agree. But with sufficient caution and preparation it seems feasible for some portion of the biohacker crowd. And the more refined and well documented the process is, the easier it seems to get.

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In the interview, A Fedintsev said that “ We have all the data published as a Google spreadsheet on our website so that researchers can see it”. Do you have a copy of that spreadsheet to post it here? What’s their website?

It could be that dilution without albumin can be very beneficial. It simplifies the process much.