Cars need oil changes to keep their engines running smoothly. Some anti-aging influencers, along with a handful of scientists, believe exchanging the plasma in your blood can do a similar thing for humans to help slow biological aging. The procedure is currently offered for thousands of dollars a session at many longevity clinics.
In a car, “you change the oil every 3,000 miles because it clears out debris,” said Dr. Eric Verdin, the president and chief executive of the Buck Institute for Research on Aging. Your blood, he said, can also accumulate potentially damaging particles that can be flushed out.
One of the first trials examining plasma exchange for anti-aging in humans, published Tuesday in the journal Aging Cell, offers early evidence that it may be able to slow the biological breakdown that comes with age, even in otherwise healthy people. The small study of 42 participants, with an average age of 65, found that those who got plasma exchange therapy over the course of a few months had lower concentrations in their blood of the biological compounds that accumulate with age, compared with a control group. The trial was sponsored by Circulate Health, a plasma exchange startup, and coauthored by Dr. Verdin, a company co-founder and head of the scientific advisory board.
Still, many other scientists who study plasma exchange are skeptical. Its anti-aging benefits for healthy people have “never been proven” in large clinical trials, said Dr. Katayoun Fomani, an associate professor and medical director of the blood bank at the University of Alabama at Birmingham, and drawing blood and replacing plasma with added fluids could put patients at risk for unnecessary medical complications without a clear payoff.
How does the procedure work?
Plasma exchange is a well-established treatment for certain blood disorders, autoimmune diseases and neurological conditions, and it’s typically covered by insurance when deemed medically necessary. It is not covered for anti-aging purposes.
During the therapy, a provider — typically a registered nurse or a technician — hooks the patient up to a machine that draws out blood. The machine separates and discards the plasma from the blood, replaces it with donor plasma or a substitute fluid, then returns the blood back to the patient. The substitute fluid often contains a mixture of saline and proteins, like albumin; in some cases, an infusion of antibodies or drugs may also be added to boost the immune system or fight certain diseases. Each session typically takes a couple of hours.
Hospitals and medical centers use plasma exchange to remove particles that hasten a disease’s progression, such as the antibodies that attack a patient’s nervous system in multiple sclerosis. But proponents of the procedure for improving health span and life span say it can be used as a preventive measure, to remove the inflammatory antibodies and proteins that may drive biological aging (the deterioration of cells and tissues).
Plasma therapy is one of several different experimental longevity procedures that involve blood transfers, including platelet-rich plasma treatment, which concentrates and injects a patient’s own blood into injured areas; and a treatment where a young donor’s blood is transfused into an older recipient.
What does the science show?
Most of the research into the anti-aging benefits of plasma exchange has been done on animals, so the findings don’t necessarily carry over to humans, said Dr. Caroline Alquist, the co-director of the Hoxworth Blood Center at the University of Cincinnati. One 2020 study on mice, for instance, found that replacing some of the animals’ blood plasma with saline and albumin, a protein believed to bind to and help remove harmful molecules, appeared to reverse biological markers of aging, especially within the brain, liver and muscle tissues.
Until now, the research in humans has focused on patients who already have an age-related disease. In one trial of nearly 350 Alzheimer’s patients, those undergoing plasma therapy over about 14 months saw slower or more stable cognitive decline than those who received a placebo treatment. Some early studies also suggest that plasma therapy may improve survival rates for people with liver disease.
In the Circulate Health trial, one group of subjects received an albumin infusion every few weeks or so; another group got the same infusion plus an antibody to fight infections; and a control group got only saline. Researchers used dozens of biological age tests to measure subjects’ blood several times during the full three-to-six-month regimen. They estimated that the albumin and antibody group decreased their biological age by about 2.6 years, while those on the albumin regimen saw a roughly one-year reduction. People who received only saline generally saw their biological age increase over the course of the trial.
What are the open questions?
While the Circulate Health study is “intriguing,” and suggests that plasma exchange appears to affect subjects’ blood composition even after the procedure, it doesn’t necessarily mean that it will help people live longer or healthier, said Dr. Jeffrey Winters, the chair of transfusion medicine at the Mayo Clinic. He said the trial was too small to prove anti-aging benefits; it also didn’t follow subjects for more than a few months, so it’s not clear how long the effects of plasma exchange last.
In the study, the authors hypothesized that treatments could get less effective over time as the body adjusts to the infusions. (The subjects typically didn’t show much difference in biological age after the third measurement, compared with the control, suggesting that the impact of the therapy could level off.)
It’s also not clear if the findings are a direct result of the treatment or if they were influenced by some other confounding factor, like the profile of the subjects, who were healthy patients in the Bay Area and recruited by Circulate Health, added Dr. Zbigniew M. Szczepiorkowski, a professor of pathology and laboratory medicine at Dartmouth Health.
Finally, while plasma exchange is a relatively safe medical procedure, it does bring risks, Dr. Winters said: The machine could fail, damaging red blood cells and inducing anemia in the patient, among other hazards. Though longevity clinics primarily use saline and albumin, donor plasma could also carry an infection over to the patient.
“Especially given the absence of evidence in the literature,” Dr. Winters said, the benefit for using plasma exchange for longevity “really isn’t there.”
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