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

Although I think this is a good starter I think we need to work out why older people’s blood has things in it which cause problems. (I think it is IL-10).

My view (and apologies to anyone bored by this) is that almost all aging problems are caused by problems with gene expression. The problems are caused by a mixture of senescence burden (causing a reduction of Acetyl-CoA in the nucleus) and mitochondrial inefficiency (causing a reduction of ATP and Acetyl-CoA in the cytosol).

Hence creating new plasma is useful to reduce the effect of SASP, but won’t fix the mitochondria.

DNA damage is another issue which is less of an issue, but harder to fix.


I thought this was quite an interesting talk from Irina Conboy. She mentions that TPE removed senescent load in aged tissue



You bring up some good points, and I’m wondering if we can discuss this a bit and broaden this point and clearly identify the (potential) issues around the blood / albumin supply as its currently defined.

Problems with Existing Young Blood Plasma (Fresh/frozen) and Albumin Supplies:

1. Potential foreign particulate material { not just virus], material that are known {known to science] and unknown. (Joseph, do you see this as an issue both in albumin and young blood plasma (fresh/frozen)?

2. Poor availability and Suboptimized Young Blood Plasma: Other than a few groups that have hit the press (e.g. Jesse Karmazin and Ambrosia, etc., and now https://resurgencewellness.com/ that Bryan Johnson used in Dallas for his experiment) its hard to know if what groups are actually providing young blood plasma for sale or as a service. So - availability of any young blood plasma (fresh/frozen) is extremely low right now. But even then, when Ambrosia was offering its services it seems the key requirement was simply age. Now there is new research that shows that ideally you would want blood that is both young and healthy, but coming from an athletic person. Currently, as far as I can tell, nobody is providing this yet. See this research and news coverage:

History of Failure, Moral and “Optics” issues:

Another issue is that from a business standpoint, this may not be a fundable opportunity (the young blood business) because of its past failures, and morally questionable fundamentals, as was mentioned in the recent Bloomberg article on Bryan Johnson:

The so-called blood boy stigma around longevity-focused plasma transfusions has meant that few people who pursue the treatment discuss it openly. Besides the obvious vampiric quality to the process, the mechanics can seem elitist and unsavory. In most cases, a wealthier person is receiving the plasma of a much younger, less well-off person. The plasma donors typically receive about $100 in gift cards for a procedure that costs roughly $5,500.

and, as the founder of Ambrosia mentioned after the FDA clamped down on him (He then started Ivy Plasma, which also was closed a year or two later (not sure exactly why):

Jesse Karmazin, CEO of Ambrosia, recently opened a new venture and is continuing to sell 1 liter of blood plasma for $8,000 and 2 liters for $12,000.

“Ambrosia was dissolved, but Ivy Plasma is open for business. Ivy Plasma provides off-label plasma treatments, which is legal,” Karmazin wrote in an email to TMC Pulse. “I can’t comment on the potential risks or benefits of this treatment due to restrictions on off-label marketing of medications by the FDA.”

Literally sucking the blood out of poor people so old wealthy people can live longer is a tough business model to market and destined to poor press coverage. But - younger, healthier people (family and friends) donating young blood to help their older relatives live longer seems like a much easier sell… with none of the “yuck” factor.

So - perhaps this is an activity better provided by some sort of non-profit organization.

What Can We Learn from the Failures?

It seems that it would be very valuable to get some input from Jesse Karmazin… given he’s started and closed two of these related businesses. I check on Linkedin and he doesn’t seem to be updating his profile, and I’m only connected at the “3rd” level - so perhaps someone here who is more directly connected to him can contact him, find out what he’s up to, and see if he’s willing to share some information. Here is his profile: https://www.linkedin.com/in/jesse-karmazin-md/

Additionally, it would be valuable more generally to learn from what people have been doing in the young blood plasma and parabiosis trials done so far.

I noted this comment from one specialist, in this article: High risks and high costs for young blood donations to older people - TMC News

clinics selling plasma from young donors are not replicating the same experimental conditions, said Vivien Sheehan, M.D., Ph.D., assistant professor of hematology-oncology at Baylor College of Medicine.

One California-based company, Ambrosia, sold participation in a clinical trial that offered each client one liter of human plasma harvested from young adults. Ambrosia charged $8,000 for that one liter, but since the FDA warning, the company has shut down. The Ambrosia trial raised major safety concerns.

“I’ve never seen an alleged trial that only had one inclusion criteria: that you be over 35,” Sheehan said. “There were no other safety measures taken to make sure you’ve never had a transfusion reaction, to make sure you can handle the volume, to make sure you’re not hypercoagulable. There was nothing in there to protect the individual and screen out people for whom this would be more dangerous. … This was clearly just an advertisement masquerading as a clinical trial. I can’t emphasize enough how disturbing it is that patients are being put at risk for something that is so unproven. The thing that is proven is that plasma can kill you. The thing that is unproven is that it would have any benefit whatsoever, so the risk-benefit ratio is completely off.”

Creative Solutions to these Problems:

  1. Albumin to start with: It seems like albumin is relatively easily available and commercially sold (with a prescription) today for around $280/liter. This seems like it would be a good place to start, and could be used immediately.

  2. Longer term solutions with Young, Athletic Blood:

Umbilical Cord Blood: I’m wondering if Umbilical Cord Blood / Stem Cells might be something that could be used for this application? This is mostly tossed out today - perhaps it could be used as the ultimate in “young blood”? Umbilical cord blood | March of Dimes

Family Donations: Perhaps there is a model by which the elderly could encourage family members (Children, Grand Children, younger relatives) to participate in a young blood donation project?

Other ideas???

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Big one, that truly would be scaled without constraints:

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Does anyone have a sense of whether this is real or does not matter:

  1. what is the impact on one’s immunity? eg say one has good protection again Covid (either by recent vaccine or recent infection of both) and one then does a ton of plasmapheresis, will one lose a lot of those valuable antibodies? What about valuable t-cells and b-cells?

Sure - synthetic biology for albumin is great, but such a product doesn’t seem likely to be available any time soon, and would require a major biotech effort. So - not really the purvue of biohackers.

And - Albumin at $280/liter seems pretty cheap and available, and perhaps the least of our concerns. I think most people here would be happy to pay $500/month for a 2 liter / monthly plasmapheresis treatment program with the currently available albumin 5%, so thats not the critical path item for our use of this technology.

I think it is an issue in the immediate period after the TPE session. When I went into Dobrik Kiprov’s clinic they asked me when I had my last vaccine shot. I mentioned I had recently gotten a shingles vaccine (a day or two earlier), and they said there was a risk that the TPE would eliminate any benefits of the vaccine I had just taken.

So - yes - issues that need to be outlined clearly, researched and considered.

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Was less thinking about cost, but rather taking out any risks of transmission of known and unknown types of communicable disease (as perhaps even other remnants, seeds of cancer?, etc) from the donor.

Especially if this is a repeat thing where one for longevity purposes will be getting exposure to many, many donors’ histories.

Personally, would be fine with doing blood “dialysis”, but would not want to keep exposing my blood system and body to things from so many other donors health pasts.


Interesting… my impression is that Albumin is a biological that is pretty well “scrubbed” before being sold. But you bring up a valid point, are there any studies that suggest increased risk with even using Albumin 5%?

Perhaps we run into the same issue we’ve had with rapamycin; all the studies are based on sick people receiving the treatment so that data could be very confounded and difficult to interpret in the case of use by healthy people like ourselves.

Have you seen any research on the related risks you’ve mentioned?

I don’t know (tried to ask the community above)

Joseph’s answer captures my ex ante thinking;

Those effects could be rare and may even be seen less in healthy individuals, but since we are generally healthy think the balance of evidence needs to be that data (and mechanistical clarity of what is picked up in tests/screening our donors, what’s is filtered out, etc) is good from a safety perspective.

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I just got an interesting idea. Let’s say I start to give blood every month and do it for a long time and that the blood is stored in a good way. Let’s say that after 15 years I start to inject myself every month with my own blood from 15 years ago. This would be a really interesting animal experiment also to do. I really like the idea that my younger self gives blood to my older self.

It feels like very costly and require special freezer but I like the idea.


Hmmmm… I agree about the appeal of this, but not sure if its a viable approach:

One site says:

Length of Storage: Make sure conditions are right

Blood banks consider six weeks to be the “shelf life” of blood, but a study from Johns Hopkins University has shown that after three weeks, red blood cells are less effective at delivering oxygen-rich cells throughout the body. Blood stored longer than three weeks becomes less flexible and less able to fit in the body’s smallest capillaries.

Depending on the blood’s future use, longer storage without refrigerated or frozen temperatures can jeopardize its viability. For example, if stored blood is used in a transfusion, the blood never regains the flexibility that it lost after the three-week mark unrefrigerated in storage.

Given the relatively rapid degradation of blood after it’s drawn, all samples should be promptly tested, refrigerated for short-term storage, and frozen for long-term storage.

Source: How Long Can Blood Be Stored? 3 Effective Tips On Blood Sample Storage

Another person on Quora says:

In the U.S., red blood cells (RBC) may be frozen, then treated for use for transfusion.

The RBC are mixed with glycerol, which replaces the water inside the RBC. The frozen RBC may be stored for up to 10 years. Really rare blood may be stored for longer.

When needed for transfusion, the RBC are thawed, diluted with a hypertonic solution to draw the glycerol out of the RBC so the water will reenter the RBC, then the RBC are washed with saline.

If the RBC are washed in an open system (using spikes to attach the washing solutions to the bag), then the final product is good for up to 24 hours from the thawing time.

If the RBC are washed in a closed system (using a sterile connection device to attach the hypertonic and washing solutions), then the product is good for a longer period, as approved by the FDA.

Quora: https://www.quora.com/Can-whole-blood-be-Frozen-come-out-then-later-thawed-and-used

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I hope we get to a point where we can grow our own blood/plasma, and all we need to do is keep a copy of the profile of are younger blood and and we can produce clone blood or better yet a gene therapy for where are blood is produced to maintain it at a young level rather then having to constantly resupply for young blood, Maybe in the future we will have a gene therapy that accesses our bones and just need to have 5 year checkups/shots to maintain the youthful state of producing blood rather then constant injections/withdrawals. However for the now term this looks like a promising therapy.


We have been doing both plasma dilution and young plasma in our clinic for the past 8 months and we are doing a large volume. We currently charge $2500 for a liter of plasma removal with replacement using saline and albumin - the procedure takes one hour to one hour and a half. We are using the latest Haemonetics machine which requires only a single IV access not two. We have also performed nearly one hundred young plasma exchanges of one liter or 2 liters over a week time frame with amazing results in reductions of biological age, HRV, deep sleep, energy, etc. we currently charge $7500 per liter of young plasma exchange.


Review the following, this would apply to many if not all blood products.

It’s a great idea! Maybe storing plasma is easier than storing blood for a long time?

Educational read;


“Guidelines for Intravenous Albumin Administration”

20170315-guidelines-for-intravenous-albumin-administration.pdf (278.9 KB)

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With all due respect, it’s difficult for people with serious illnesses to get PLEX… insurance won’t even approve it for many neurological and immune/autoimmune diseases.

As someone with a serious chronic illness who has been trying to get PLEX for years (have done Rituxan and exosomes as well as other MABs, pre-Rapamycin), I would put forth that it should be reserved for those who need it most, as it’s not widely available. If that changes in the future, great! The costs could come down for everyone…

Also, I’ve heard from other patients that it’s not the easiest treatment, but everyone is different.

We are not speaking about insurance paying for this.

We are speaking about off label, longevity use, expermential use, pay out of pocket/self pay.

Such as biohack this as a do it your self.

The easiest way/least expenssive way;

Remove 1 unit{500ml is a unit of blood] of whole blood.{this would also reduce your iron level, a side benefit]

Then infuse 500ml of 5% albumin,
by gravity feed, you do not require a pumping system.

All standard off the shelf equipment/disposables and off the shelf 5% albumin.

You will achieve diluting your whole systemic blood supply.

All for less than $500.00{500ml 5% albumin, evacuated bottle to remove blood, infusion line set,
catheter/winged infusion set, blood removed line] as a do it yourself biohack.

Yes, “clinics” charging $2,500.00 per treatment and up will not like ithis.

This entire conversation is totally experimental.

Shamelessly copying from Blagosklonnys paper;

“If you wait until you are ready, it is almost certainly too late.” ~ Seth Godin

Shall we start a skunk works?

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