Blood Purification
Therapeutic plasma exchange
Therapeutic plasma exchange (TPE) removes and replaces the liquid part of your blood while returning the blood cells. At St. George Hospital, it is available for individual assessment across our condition programmes, including longevity. Your diagnosis, findings and treatment goals determine whether it belongs in your plan.
What is therapeutic plasma exchange?
The blood contains cells suspended in plasma. In apheresis, a machine separates these components outside the body. During TPE, the plasma is removed and replacement fluid is given with the returning blood cells. Depending on the indication, the replacement may contain albumin or donor plasma.
This is a broad removal process: useful proteins, including antibodies and clotting factors, can be removed alongside the intended target. It differs from immunoadsorption and H.E.L.P. apheresis, which process the plasma differently. Your physician selects the method for a specific clinical reason.
Your path to a treatment decision
Review
Your physician reviews your diagnosis, current medicines, circulation, blood results and suitability for venous access.
Plan
Discuss the intended benefit, replacement fluid, relevant risks and alternatives before deciding together.
Treatment and review
The team monitors the exchange and reviews your response against the agreed treatment goal.
Where it fits in your programme
St. George Hospital offers TPE for individual consideration across its condition programmes, including Lyme disease, Long COVID, oncology and longevity. It is a possible treatment module, not an automatic part of admission or a recommendation based on a programme name.
The consultation brings together your medical history, current treatment and laboratory findings. Ask which problem the exchange is intended to address, how progress will be measured and what alternatives are available.
Explore your programme
- Chronic Lyme disease
Assessment within a wider plan for your diagnosis and persistent symptoms.
- Long COVID and ME/CFS
Discuss the clinical rationale and the research relevant to plasma exchange.
- Integrative oncology
Any apheresis decision is coordinated with the wider oncology plan.
- Longevity
An individual discussion of health goals, findings and research on ageing-related markers.
Research and clinical context
The American Society for Apheresis guideline evaluates apheresis by specific disease and clinical situation. Evidence for established uses cannot simply be transferred to another diagnosis. In Long COVID, a 2025 trial involving 50 participants found no improvement over sham exchange on the efficacy outcomes studied.
For longevity, a small 2025 randomized study examined TPE regimens and ageing-related biomarkers. Changes in these markers do not establish a longer life or prevention of disease. These distinctions are part of deciding whether an individual treatment attempt is reasonable.
Safety, preparation and costs
The assessment includes circulation, blood counts and clotting, kidney function, medicines and the proposed replacement fluid. Possible complications include low blood pressure, citrate-related symptoms, allergic reactions, changes in clotting and problems related to venous access. The plan includes monitoring and follow-up appropriate to your situation.
The number and spacing of sessions are individual. The International Office explains how to send your records for medical review and obtain a written estimate. Read costs and insurance before planning your stay.
Frequently asked questions
Is plasma exchange included in every programme?
No. It is available for assessment across our programmes, including longevity, but availability does not mean that every patient needs it. Your physician explains the reason for proposing it, the alternatives and how the result would be assessed.
How is TPE different from immunoadsorption?
TPE removes plasma and replaces it with a replacement fluid. Immunoadsorption processes the plasma through an adsorber and returns it. The choice depends on the substances being targeted and your clinical situation.
Can plasma exchange extend life?
Research has examined changes in ageing-related biomarkers. Those findings do not establish longer life or prevention of age-related disease. A longevity consultation should distinguish these research measures from health outcomes that matter to you.
How do I find out whether TPE is appropriate and what it costs?
Send a short inquiry to the International Office. Medical review comes before a treatment recommendation and written cost overview; the planned course is individual.
References
- Guidelines on the Use of Therapeutic Apheresis in Clinical Practice: The Ninth Special Issue. J Clin Apher 2023. PMID 37017433
- Plasma exchange therapy for the post COVID-19 condition: a phase II, double-blind, placebo-controlled, randomized trial. Nature Communications 2025. PMID 39994269
- Multi-Omics Analysis Reveals Biomarkers That Contribute to Biological Age Rejuvenation in Response to Single-Blinded Randomized Placebo-Controlled Therapeutic Plasma Exchange. Aging Cell 2025. PMID 40424097
Send a free inquiry
The initial inquiry is free of charge. The International Office reviews your message and your case directly and gets back to you.
- Phone
- +49 8061 398-0
- Hours
- Mon–Thu 08:00–17:00, Fri 08:00–14:00 German time (CET/CEST); in the US Mon–Thu 2–11 a.m. ET, Fri 2–8 a.m. ET.
Munich Airport (MUC), about 60 minutes by car.