Plasmapheresis for Longevity: One Trial Reports Accelerated Biological Aging, Another Shows 2.6-Year Reversal with Supplementation

The efficacy of plasmapheresis in reversing human biological aging is currently yielding contradictory results in recent clinical trials. While some research indicates a potential acceleration of aging markers when the procedure is performed without specific plasma component replacement, other studies report significant biological age reductions, particularly when supplemented with intravenous immunoglobulin. This divergence highlights the critical role of procedural specifics in longevity interventions.

A recent study by Pavel Borsky et al. (2025), involving 34 healthy middle-aged adults, investigated the effects of plasmapheresis without the replacement of young plasma or albumin. Participants underwent 4 to 8 rounds of the procedure over 18 weeks. Contrary to expectations of rejuvenation, epigenetic clocks such as DNAmGrimAge, the Hannum clock, and DunedinPACE showed increases, suggesting an acceleration of biological aging. Prof. Steve Horvath, a prominent figure in epigenetic aging research, commented on these "disappointing results," stating, > "Instead of showing rejuvenation, epigenetic clocks like DNAmGrimAge increased."

Conversely, a separate clinical trial by Fuentealba and Kiprov (2025), conducted by Circulate Health and the Buck Institute for Research on Aging, presented more optimistic findings. This study, involving 42 participants over 50, utilized therapeutic plasma exchange (TPE) with replacement solutions, including intravenous immunoglobulin (IVIG). The research reported an average biological age reduction of 1.32 years with TPE alone, and a more significant 2.61-year reduction when TPE was combined with IVIG. David Furman, PhD, senior author of the Buck Institute study, stated that "this study marks the first step in demonstrating that plasma exchange can significantly improve key mechanisms of biological aging."

The contrasting outcomes underscore the importance of the specific protocols used in plasmapheresis for anti-aging purposes. The Borsky study's findings suggest that simply removing aged plasma without adequate replenishment may induce a stress response or deplete beneficial components, leading to an adverse effect on biological age. Prof. Horvath speculated in his tweet that > "Maybe replacement with young plasma or albumin is important," a point supported by the positive results from the Fuentealba study which incorporated such replacements.

While plasmapheresis is an established medical treatment for various conditions, its application for longevity remains experimental and complex. The divergent results indicate that the concept of "blood cleansing" for rejuvenation is not straightforward and depends heavily on the precise methodology. Further research is crucial to identify optimal protocols, including the type and volume of replacement fluids, to ensure safety and efficacy in the pursuit of human healthspan extension.