Can You Give Your Blood an “Oil Change”? Plasma Exchange and the Longevity Question

The comparison was probably inevitable. Cars periodically need their oil changed, so why not remove some of the aging material accumulating in human blood and replace it with something cleaner?

That analogy has helped move therapeutic plasma exchange, or TPE, from hospital apheresis units into the longevity market. Treatments that were once primarily associated with serious autoimmune, neurologic and hematologic diseases are now being offered to otherwise healthy adults interested in biological aging, inflammation, environmental toxins and microplastics.

There is legitimate science behind some of this interest. There is also a large gap between changing what is circulating in someone's blood and demonstrating that the person will remain healthier or live longer.

This distinction fits within a broader principle we discuss throughout HormoneSynergy®: biomarkers and advanced interventions are most useful when they answer a clinical question and have some reasonable path to changing care. See Medicine, Not Marketing and our overview of the science of longevity medicine.

What Plasma Exchange Actually Does

During therapeutic plasma exchange, blood is removed and separated into its cellular components and plasma. A substantial portion of the plasma is discarded, the blood cells are returned, and the missing volume is replaced, commonly with albumin and other fluids.

The procedure is effective in certain diseases precisely because it is capable of removing large quantities of substances circulating in plasma. A one-plasma-volume exchange can remove roughly 60 to 70 percent of an intravascular substance during the procedure.

That removal is not selective. If a harmful autoantibody is circulating in the plasma, it may be removed. So are normal immunoglobulins, coagulation proteins, inflammatory molecules, transport proteins and other plasma constituents. Clinicians who perform TPE for established medical indications understand these effects and manage them accordingly.

The issue in longevity medicine is not whether plasma exchange changes the blood. It clearly does. The question is whether exposing a healthy person to those changes produces a meaningful long-term benefit.

The Study Behind the “2.6 Years Younger” Claim

A 2025 study published in Aging Cell attracted considerable attention because researchers reported changes in epigenetic measures of biological age following therapeutic plasma exchange.

The study enrolled 44 people, with 42 completing the trial. Participants received different schedules of plasma exchange, plasma exchange combined with intravenous immunoglobulin (IVIG), or sham treatment.

At an intermediate measurement, monthly TPE was associated with an average biological-age reduction of approximately 1.3 years. The largest reported change, approximately 2.6 years, occurred in the group receiving TPE combined with IVIG.

The number frequently used to describe the benefits of plasma exchange did not come from plasma exchange alone.

There is another important detail. At the study's later measurement, the researchers reported no significant biological-age differences between any treatment group and the sham group. The authors suggested that compensatory biological mechanisms might have reduced the earlier effect.

The investigators also reported that most of the biological-age clocks differed among the groups before treatment began. When changes within individual groups were corrected for multiple comparisons, none of the clocks showed a statistically significant change from baseline.

Most importantly, the study did not establish that anybody actually became clinically younger. The researchers did not demonstrate that changing these measurements translated into fewer chronic diseases, longer survival or sustained improvements in healthspan.

The study is registered as NCT06534450 on ClinicalTrials.gov. The registry describes therapeutic plasma exchange with albumin replacement, TPE combined with IVIG and sham treatment.

A Biomarker Is Not the Same as an Outcome

Epigenetic clocks are valuable research tools. Some are associated with disease risk and mortality, and they may eventually help researchers determine whether an intervention is influencing biological aging.

They are not interchangeable with healthspan.

If a treatment moves an aging clock by two years, we still need to know whether the person has fewer heart attacks, develops dementia later, remains physically independent longer, develops fewer cancers or ultimately lives longer.

None of those questions has been answered for plasma exchange in healthy adults.

This is an important issue throughout longevity medicine. Biological aging is complex, and no single laboratory value, biological-age clock or intervention tells us the whole story. Our HormoneSynergy® Longevity Medicine Model focuses instead on clinically meaningful systems and risk factors that can be measured and followed over time.

There Is Also a Significant Commercial Connection

The trial should not be dismissed because of industry involvement, but that involvement deserves to be visible when the results are used to market the treatment.

The published study identifies investigators associated with Circulate, a company commercializing therapeutic plasma exchange for longevity. The Buck Institute's own disclosure states that the study was supported by Circulate, Inc. It also identifies Eric Verdin, MD, PhD, as president and CEO of the Buck Institute and a co-founder of Circulate.

Industry-supported research is common throughout medicine. It does not mean that the results are invalid. It does mean that replication by investigators without a financial interest becomes especially important before a small biomarker study is treated as evidence of clinical benefit.

Another Human Study Found a Very Different Aging Signal

A separate 2025 study published in Scientific Reports followed healthy plasma donors undergoing repeated plasmapheresis. Instead of showing epigenetic rejuvenation, investigators observed increases in several measures associated with biological aging, including DNAmGrimAge and DunedinPACE, along with decreases in total protein and albumin.

This study should not be used to claim that therapeutic plasma exchange accelerates aging. The procedures were not identical. The donors underwent plasmapheresis without the albumin replacement used in therapeutic plasma exchange.

It does show why the field needs larger independent trials before confident conclusions are justified. Two related interventions can produce quite different biomarker signals depending upon how the procedure is performed.

An earlier 2022 human study published in GeroScience had reported that repeated therapeutic plasma exchange was associated with a shift toward a younger systemic proteomic profile. That study helped provide part of the biological rationale for subsequent longevity research, but it was small and was not designed to establish longer healthspan or lifespan.

What About PFAS, “Toxins” and Microplastics?

This part of the discussion has become more interesting.

A 2022 randomized clinical trial in JAMA Network Open involving 285 Australian firefighters found that repeated plasma donation lowered several PFAS compounds in the blood. Plasma donation was more effective than ordinary blood donation for some of the measured compounds.

That is a real finding. It demonstrates that removing plasma can reduce the concentration of certain persistent chemicals circulating in blood.

A 2026 study published in the Journal of Clinical Apheresis measured microplastics before and after 174 therapeutic plasma exchange procedures in 114 patients and reported lower circulating microplastic levels following TPE.

There was an unexpected complication: plastic from the apheresis tubing itself appeared to introduce microplastics into the circulation, particularly when patients started with relatively low levels.

The larger question remains unanswered. Lowering the concentration of PFAS or microplastics in blood does not tell us how much has been removed from tissues throughout the body, nor does it establish that the reduction prevents disease or extends life.

This is why the word detox needs context. Demonstrating that a substance can be removed from circulating blood is different from demonstrating that removal improves a meaningful health outcome.

FDA Cleared Does Not Mean Proven for Longevity

The equipment used to perform therapeutic plasma exchange can be FDA cleared through the 510(k) medical-device pathway. FDA records for the Spectra Optia Apheresis System, for example, list the device as an automated therapeutic blood-cell and plasma separator and record a finding of substantial equivalence.

That should not be interpreted as FDA approval of plasma exchange as an anti-aging treatment.

There is currently no FDA authorization establishing therapeutic plasma exchange as a treatment proven to reverse aging, improve healthspan or extend lifespan in healthy adults.

The distinction matters. A device can be legally cleared for performing therapeutic plasma exchange without the FDA having concluded that elective plasma exchange slows human aging.

Where We Land

Therapeutic plasma exchange should not be confused with an invented wellness treatment. It is established medicine with important applications, and emerging research into aging biology deserves continued attention.

The longevity claim is much further ahead than the clinical evidence.

We have small human studies showing that plasma exchange can alter molecular biomarkers. We have evidence that plasma removal can lower some PFAS compounds and circulating microplastics. We also have conflicting biological-age findings and no evidence yet showing that healthy people receiving elective TPE experience less cardiovascular disease, less dementia, less cancer, better physical function or longer survival.

For someone with a life-threatening disease in which plasma exchange has demonstrated benefit, the calculation is very different from that of a healthy person paying thousands of dollars to modify an aging biomarker.

That person deserves to know exactly what has been demonstrated and what remains theoretical.

At this point, therapeutic plasma exchange for longevity belongs in the category of interesting experimental medicine. It does not yet belong in the category of proven longevity care.

For more discussion of preventive testing, biological aging and evidence-based longevity medicine, visit the HormoneSynergy® Longevity Medicine Resource Library.

Research & References

1. Fuentealba M, Kiprov D, Schneider K, et al. 2025. “Multi-Omics Analysis Reveals Biomarkers That Contribute to Biological Age Rejuvenation in Response to Single-Blinded Randomized Placebo-Controlled Therapeutic Plasma Exchange.” Aging Cell. Read the full study. DOI: 10.1111/acel.70103.
2. Borsky P, Holmannova D, Parova H, et al. 2025. “Human Clinical Trial of Plasmapheresis Effects on Biomarkers of Aging (Efficacy and Safety Trial).” Scientific Reports. Read the full study.
3. Gasiorowski R, Forbes MK, Silver G, et al. 2022. “Effect of Plasma and Blood Donations on Levels of Perfluoroalkyl and Polyfluoroalkyl Substances in Firefighters in Australia: A Randomized Clinical Trial.” JAMA Network Open. Read the full study. DOI: 10.1001/jamanetworkopen.2022.6257.
4. Weinstein R, Yuksel ZS, Anderson C, et al. 2026. “Can Plasma Exchange Be Used to Lower the Circulating Burden of Microplastics in Human Patients?” Journal of Clinical Apheresis. Read the full study. DOI: 10.1002/jca.70135.
5. Kim D, Kiprov DD, Luellen C, et al. 2022. “Old Plasma Dilution Reduces Human Biological Age: A Clinical Study.” GeroScience. Read the full study. DOI: 10.1007/s11357-022-00645-w.

Additional Documentation

• ClinicalTrials.gov: NCT06534450 — Effects of Therapeutic Plasma Exchange on Age-Related Biomarkers and Epigenetics
• FDA 510(k) Record: Spectra Optia Apheresis System, K183081
• Buck Institute: Trial summary, funding and investigator disclosures

Frequently Asked Questions

Is therapeutic plasma exchange FDA approved for anti-aging?

No FDA authorization has established therapeutic plasma exchange as a treatment proven to reverse aging or extend lifespan in healthy adults. Apheresis devices may be FDA cleared for therapeutic plasma exchange, which is different from demonstrating that the procedure is effective for longevity.

Does plasma exchange remove toxins?

Plasma removal can reduce certain substances circulating in blood. Human research has shown reductions in some PFAS compounds, and newer research suggests TPE can reduce circulating microplastics. Whether those reductions lower total-body burden or improve long-term health remains unknown.

Does plasma exchange reverse biological age?

A small 2025 study reported improvements in several epigenetic measures of biological age, particularly when TPE was combined with IVIG. The strongest effect was seen at an intermediate measurement and did not remain significantly different from sham at the later measurement. The study did not demonstrate that people lived longer or developed fewer age-related diseases.

Is therapeutic plasma exchange safe?

TPE has decades of clinical use and is generally well tolerated when appropriately performed. It is still a significant medical procedure. Potential effects include hypotension, citrate-related low calcium, allergic reactions, vascular-access complications and temporary reductions in immunoglobulins and coagulation proteins. The acceptable balance of risk and benefit depends heavily on why the procedure is being performed.

This article is for educational purposes and is not intended as individual medical advice. Decisions about therapeutic plasma exchange or other medical procedures should be made with a qualified clinician familiar with the individual's medical history, indications, risks and alternatives.