Connect the circulatory system of an old mouse with that of a young mouse and the old mouse gets younger!
The concept was popularized in the HBO series Silicon Valley, in which a tech billionaire uses a young “blood boy” as a source of young plasma transfusions for his longevity treatments.
Follow-up studies confirmed that young blood can make an old mouse’s tissues and organs appear younger. The opposite is also true—transfuse younger animals with blood from older ones and aging accelerates.
Now, in a new twist called “Total Plasma Exchange” or TPE, it might be possible to get these same benefits in humans without needing your very own blood boy.
Recent clinical human trials using TPE have already reported positive results for the treatment of various age-related diseases such as Alzheimer’s—slowing disease progression by over 65%.
In today’s blog, I’ll discuss what Total Plasma Exchange (TPE) is, how it works, its benefits for longevity, and why I’m personally using TPE as a key part of my longevity practices.
Let's dive in…
What Exactly is TPE & How Does It Work?
Therapeutic (or Total) Plasma Exchange (TPE) is a medical procedure that removes the liquid part of blood (plasma), the portion that contains proteins, antibodies, toxins, inflammatory agents, and other substances—and replaces the old plasma with fresh saline and albumin. Historically, TPE has been successfully used to treat a variety of diseases, including autoimmune diseases, neurological disorders, hematological disorders, and poisoning.
In the case of Alzheimer's, the AMBAR clinical trial has shown that patients treated with TPE progressed 66% slower than their control group peers. Additionally, a study published in 2021 found that 78.7% of multiple sclerosis patients showed clinical improvement after TPE.
Now the question is: can TPE help with longevity and increase healthspan?
Can TPE Improve Longevity & Healthspan?
In recent studies, it’s been suggested that as we age, our blood accumulates harmful substances (e.g. cytokines, toxic autoreactive antibodies), which could be removed via the TPE process. One study found that TPE increased the lifespan of mice by 30%.
Dr. Dobri Kiprov, an internationally renowned pioneer and expert in Therapeutic Apheresis, Immunotherapy, Long Covid, and Age-Related Disorders, was the first to publish about effect of TPE on aging.
In 2022, Dr. Kiprov teamed up with Irina Conboy to publish a landmark study in the journal GeroScience, showing that TPE can indeed have positive, rejuvenative effects.
The study revealed that human biological aging and many of the debilitating conditions that come with it are driven by excesses of molecular bad actors that accumulate in the blood as people age. These circulating blood proteins include cytokines, toxic autoreactive antibodies, and biomarkers for specific diseases.
The researchers studied the effects of multiple rounds of TPE on people of varying ages.
Their findings showed indicators of rejuvenation in the samples, including reduced “inflammaging,” diminished protein markers of neurodegeneration and cancer, diminished resistance to cell death and accumulation of senescent cells, lowered DNA damage, and improved immunity.
In a recent conversation I had with Dr. Kiprov, he offered this advice and recommendation:
“We recommend 6 treatments because that has been our experience so far in a controlled clinical environment. After the 6 treatments, all the parameters improved dramatically. The improvements include a reduction in aging clocks between 2 to 5 years, and decreased muscle loss.”
Kiprov’s scientific partner, Dr. Irina Conboy, suggested that there is a preventive capacity against age-associated neurological disease as well.
As she puts it:
"By understanding how rapid and drastic dilution of age-elevated proteins in blood serum works, we can eventually make all tissues and organs younger."
How & Why I’m Using TPE
I refer to my TPE treatments as my "longevity oil change."
Just last week, I had my fourth (out of 6) annual TPE treatment through an add-on to my APEX Membership at Fountain Life, removing 2.2 liters of old plasma (e.g., inflammatory factors) and following Dr. Dobri Kiprov’s protocol: replacing the plasma with a mixture of 5% human albumin and saline. I do this protocol at Fountain’s headquarters Center in Orlando, Florida (Lake Nona) and occasionally at the offices of Dr. Sheldon Jordan in Santa Monica.
My experience with TPE has been relatively smooth and easy. The entire process takes about 3 hours from start to finish. During the process, I’m usually on Zoom, or taking phone calls. One of my friends put on his Vision Pro headset and watched a movie.
I show up early, about 9am after having breakfast and hitting the restroom. The nurse puts one needle in my left arm that extracts blood, flowing it into the TPE machine where the red and white cells are separated from the plasma, eventually to be fed back into my body. Another needle is placed in my right arm where the fresh plasma and retained red and white cells are returned into my circulation.
During that afternoon, I will typically feel a bit tired (after all, they have removed some portion of my oxygen-carrying red blood cells in the process), and on one occasion recently I got a bit woozy and hypoglycemic towards the end of the 3 hours, but quickly recovered. Typically, I’m feeling great 24 to 48 hours later, playing tennis and back in the gym. I also feel clear-headed and have great energy.
After I finish my 6th TPE treatment this summer, I’ll repeat my TrueAge tests and see if it’s had any impact on my aging clocks.
I'm also happy to announce that at least two of the Faculty on my upcoming Platinum Longevity Trip will be discussing the latest developments with TPE treatments, specifically: Helen Messier, PhD, MD, Chief Medical Officer of Fountain Life, and Sheldon Jordan, MD, Neurological Associates, The Interventional Group.
Why This Matters
With the increasing prevalence of both inflammatory and autoimmune diseases worldwide and the growing evidence of the damage these cause, the demand for TPE treatments will continue to increase.
According to some estimates, the global TPE market will balloon from $1.5 billion in 2022 to $2.9 billion by the end of 2031, growing at a CAGR of 7.5%.
TPE represents just a taste of the tremendous momentum that longevity science has right now, and the growing list of longevity-related therapeutics now becoming available.
We are edging closer toward a dramatically extended health span—where “100 years old can become the new 60.”
We are truly on the brink of a healthspan revolution. As we trend towards “Longevity Escape Velocity,” and we are each blessed with additional decades of health, what will you create? How will you spend the extra 20 or 30 healthy years of your life?