Young Plasma Exchange (TPE)
Therapeutic plasma exchange using plasma from young healthy donors (ages 18-25) to rejuvenate biological markers and potentially reverse aspects of aging
Bottom Line
Young Plasma Exchange is one of the most cutting-edge longevity interventions available. The May 2025 Buck Institute clinical trial showed a 2.6-year reduction in biological age using multi-omic biomarkers, the first placebo-controlled human trial to demonstrate this effect.
Ben Greenfield calls it "probably the biggest game-changer I've ever experienced for feeling like I've wound back the clock to eighteen years old." However, it's expensive, only available at specialized clinics (primarily in Texas), and long-term effects remain unknown.
Promising early science, dramatic anecdotal reports, but still experimental. For those with resources seeking cutting-edge longevity interventions, this is worth considering. For most people, stick with proven interventions first.
Science
Mechanisms:
- Dilution of pro-aging factors: Removes accumulated inflammatory proteins, damaged immunoglobulins, and pro-aging factors from circulation
- Introduction of young plasma factors: Young plasma contains growth factors, peptides, exosomes, and regenerative components
- Immune system reset: May help recalibrate immune function
- Epigenetic changes: Multi-omic analysis shows changes in epigenome, proteome, metabolome, and glycome
Key Research:
- Fuentealba et al. (2025) in Aging Cell: First randomized placebo-controlled trial
- 44 adults over 50 years old
- Bi-weekly TPE + IVIG: 2.61 year biological age reduction
- TPE alone: 1.32 year reduction
- Measured using 36 epigenetic clocks
- Improvements in balance and strength
- Safety profile: 0.42% mild allergic reaction rate (1 in 240 procedures)
What Was Measured:
- Epigenetic clocks (DNA methylation patterns)
- Proteome changes
- Metabolome shifts
- Glycome modifications
- Immune system markers
- Physical measures (balance, strength)
Earlier Animal Research:
- Parabiosis studies (connecting circulatory systems of young and old mice) showed rejuvenation effects
- Young blood factors improved cognitive function, muscle repair, and organ function in aged animals
Limitations:
- Small sample size (44 participants)
- Long-term effects unknown
- Optimal frequency and duration unclear
- Mechanism not fully understood
- May be dilution effect rather than young factors specifically
Supporting Studies
6 peer-reviewed studies
View all studies & compare research →Practical Protocol
Standard Protocol (Austin Regenerative Therapy):
Day 1:
- Remove ~1 liter of old plasma
- Replace with IV vitamins and saline
Day 2:
- Remove second liter of plasma
- Infuse 2 liters of Young Fresh Frozen Plasma (yFFP)
- Plasma from healthy donors aged 18-25
Buck Institute Trial Protocol:
- Bi-weekly TPE with or without IVIG
- Or monthly TPE
- Duration: Several months
Procedure Details:
- Takes several hours per session
- IV access required
- Performed at specialized clinics
- Requires medical supervision
Optional Add-Ons (at some clinics):
- IVIG (intravenous immunoglobulin) - enhanced results in trial
- Targeted joint injections with young plasma
- Stem cell combinations
- Exosome infusions
Post-Procedure:
- Most resume normal activity same day
- Some report immediate energy boost
- Monitor for allergic reactions
- Follow-up testing at 3-6 months recommended
Risks & Side Effects
Known Risks:
- Allergic reactions: 0.42% rate (mild, in Buck trial)
- Infection risk: Standard IV procedure risks
- Transfusion reactions: Possible with any blood product
- Citrate toxicity: Can occur during plasmapheresis
- Hypotension: Temporary blood pressure drop possible
Potential Concerns:
- Unknown long-term effects: Procedure too new
- Immune system impact: Unclear long-term immune effects
- Disease transmission: Extremely low risk with screened donors
- Regulatory status: Not FDA-approved for anti-aging
Contraindications:
- Active infections
- Bleeding disorders
- Severe cardiovascular disease
- Allergy to blood products
- Pregnancy
- Immunocompromised states (relative)
Legal Status:
- Available in Texas and some other states
- Regulatory landscape varies
- Not covered by insurance for longevity purposes
Risk Level: Moderate (experimental procedure, limited long-term data)
Who It's For
Ideal Candidates:
- Those with significant resources for cutting-edge longevity
- People who have optimized foundational interventions first
- Individuals over 50 seeking biological age reversal
- Those comfortable with experimental procedures
- People who can travel to specialized clinics
May Benefit:
- Those with accelerated biological aging
- Individuals with high inflammatory markers
- People seeking performance/recovery enhancement
- Longevity-focused biohackers
Should Skip:
- Those seeking proven, affordable interventions
- People who haven't optimized basics (sleep, exercise, nutrition)
- Anyone with contraindications listed above
- Those uncomfortable with experimental procedures
- People who can't afford the cost
Prerequisites:
Should have already optimized: sleep, exercise, nutrition, stress management, and basic supplements before considering advanced interventions like this.
How to Track Results
What to Measure:
Before/After Testing:
- Biological age testing (epigenetic clocks)
- TruDiagnostic
- Elysium Index
- GrimAge, PhenoAge clocks
- Comprehensive blood panel
- Inflammatory markers (CRP, IL-6)
- Metabolic markers
Subjective Measures:
- Energy levels
- Cognitive clarity
- Skin appearance
- Recovery from exercise
- Sleep quality
Physical Measures:
- Grip strength
- Balance tests
- Body composition
Timeline:
- Immediate: Some report same-day energy boost
- 1-4 weeks: Subjective improvements
- 3-6 months: Biological age testing recommended
Signs It's Working:
- Improved energy and vitality
- Better cognitive function
- Enhanced recovery
- Reduced biological age on testing
- Improved inflammatory markers
Top Products
Clinics Offering Young Plasma Exchange:
Austin Regenerative Therapy (Texas) - Ben Greenfield's choice - Young Plasma™ protocol - austinregen.com
Circulate Health
- FDA-cleared TPE system
- Connected to Buck Institute research
- Available at 20+ functional health clinics
NextHealth
- Multiple locations
- Various regenerative protocols
Testing:
- TruDiagnostic - Epigenetic age testing
- Elysium Health Index - Biological age
Note: Always verify clinic credentials and doctor qualifications. This is a medical procedure requiring proper oversight.
Cost Breakdown
Estimated Costs:
| Treatment | Approximate Cost |
|---|---|
| Single TPE session | $3,000-5,000 |
| Full protocol (2-day) | $10,000-15,000 |
| With add-ons (stem cells, etc.) | $15,000-25,000+ |
| Repeat treatments | Additional cost each time |
Additional Costs:
- Travel to Texas/specialized clinic
- Pre/post testing ($500-2,000)
- Accommodation during treatment
- Follow-up visits
Insurance:
- Not covered for longevity/anti-aging
- May be covered for specific medical conditions (rare)
Cost-Per-Benefit:
Very high cost. Consider only after optimizing free/low-cost interventions (sleep, exercise, nutrition, cold exposure, sauna, etc.).
Podcasts
#036 Judith Campisi, Ph.D. on Cellular Senescence, Mitochondrial Dysfunction, Cancer & Aging
Dr. Judith Campisi discusses cellular senescence, its role in aging, and potential therapeutic...
The Surprising Science Of Injecting Young Blood, Salmon Sperm & Stem Cells Into Your Face (And Other Places) With Dr. Khanh Nguyen
Ben Greenfield visits Dr. Khanh Nguyen at Austin Regenerative Therapy for three days of advanced...
Discussed in Podcasts
Young Plasma Exchange Discussion
I think the other question though is, you know, cells also build up kind of these aggregates and other, you know, nasty kind of by-projects and accumulate what happens to them.
Young Plasma Exchange Discussion
I had read a study, I think it was one of your really good reviews that you published, where you talked about bone marrow transplants.
Young plasma exchange: replacing old plasma with donor plasma from 18-25 year olds
Therapeutic plasma exchange swaps old plasma for albumin. Young plasma exchange replaces it with plasma from donors aged 18-25.
Who to Follow
Researchers:
- Eric Verdin, MD - CEO of Buck Institute, Circulate Health co-founder
- David Furman, PhD - Buck Institute researcher, multi-omics expert
Practitioners:
- Ben Greenfield - Prominent advocate, personal experience
- Darshan Shah, MD - NextHealth founder
Clinics:
- Austin Regenerative Therapy (Dr. Khanh Nguyen)
- Circulate Health network
Synergies & Conflicts
Pairs Well With:
- Sauna - Heat shock proteins, detox
- Cold exposure - Hormesis
- Time-restricted eating - Autophagy
- Stem cell therapies (often combined at clinics)
- NAD+ IV infusions
Optimize First:
Before considering TPE, ensure these are optimized: - Sleep quality - Exercise routine (Zone 2 + strength) - Nutrition - Stress management - Basic supplements (D, omega-3, etc.)
Post-Treatment Support:
- Anti-inflammatory diet
- Adequate protein for recovery
- Continued exercise
- Sleep optimization
Testing Stack:
- Biological age test before/after
- Comprehensive blood panel
- Inflammatory markers
What People Say
Ben Greenfield's Experience:
Ben Greenfield received young plasma exchange at Austin Regenerative Therapy and reported: - Immediate improvement in energy and vitality - Weight went from 185 to 202 lbs (muscle, no fat gain) - Dramatically improved skin appearance - "Biggest game-changer I've ever experienced" - Named it one of his Top 10 Biohacks of 2025
Clinical Trial Results:
Community Feedback:
Caveats: