Clinical Reference · Blood Purification Modalities
Plasma-Based
Therapies
A comprehensive reference for apheresis, filtration, and plasma signaling technologies used in advanced longevity and clinical protocols.
9
Modalities
4
Categories
RX
Supervised Only
Medical Supervision Required
This technical reference is for educational purposes only. All extracorporeal and apheresis-based therapies carry inherent risks and must be conducted exclusively in a certified clinical environment under direct physician oversight. Content does not constitute medical advice or treatment guidance.
Clinical Stratification
Comparative Therapeutic Matrix
| Therapy | Category | Intensity | Primary Mechanism | Evidence | Risk |
|---|---|---|---|---|---|
| DFPP | Filtration | Double filtration; size-selective removal of pathogenic macromolecules (fibrinogen, IgG, LDL). | Clinical | Moderate | |
| Plasma Ozonation | Signaling | Hormetic oxidative stimulus; acute NRF2 pathway activation and antioxidant enzyme upregulation. | Emerging | Low–Mod | |
| TPE / PEX | Exchange | Total plasma volume exchange; broad removal of cytokines, autoantibodies, and pro-inflammatory proteins. | Clinical | Mod–High | |
| INUSpheresis® | Adsorption | Precision elution of environmental toxins, lipopolysaccharides, and heavy metal conjugates. | Emerging | Moderate | |
| Young Plasma Infusion | Experimental | Hypothesized GDF11, TIMP2 signaling and systemic youth-factor enrichment via heterochronic exchange. | Pre-Clinical | Unknown | |
| LDL Apheresis | Filtration | Precision removal of atherogenic lipoproteins (ApoB, Lp(a), LDL-C) via affinity columns. | Established | Moderate | |
| EBO2 / EBOO | Signaling | Extracorporeal blood ozonation and oxygenation combined with micro-filtration of lipids and proteins. | Emerging | Low–Mod | |
| Immunoadsorption | Adsorption | Highly targeted elution of pathological antibodies (anti-dsDNA, AChR-Ab) using protein A or antigen-specific columns. | Clinical | Moderate | |
| Cryofiltration | Filtration | Temperature-dependent precipitation and removal of cryoglobulins and immune complexes. | Clinical | Mod–High |
Apheresis Process
Extracorporeal Circuit — How It Works
STEP 01
Venous Access
Large-bore IV or central catheter placed for continuous blood draw.
STEP 02
Anticoagulation
Heparin or citrate infused to prevent circuit clotting.
STEP 03
Separation
Centrifuge or membrane separator isolates plasma from blood cells.
STEP 04
Filtration / Tx
Target molecules removed or modified per modality (adsorption, ozonation, exchange).
STEP 05
Reinfusion
Treated plasma recombined with cells and returned intravenously.
STEP 06
Monitoring
Vitals, pressure, and electrolytes tracked throughout session.
Modality Classification
Apheresis & Filtration Taxonomy
Signaling & Modulation
01
Plasma Ozonation
Delivers a controlled oxidative dose ex vivo; activates NRF2-mediated antioxidant gene expression and modulates inflammatory cytokine release upon reinfusion.
02
EBO2 / EBOO
Combines ozonation with high-flow oxygenation and integrated microfiltration — removes lipid deposits, oxidised proteins, and microplastics simultaneously.
Selective Precision Removal
03
LDL Apheresis
Affinity columns or dextran sulfate adsorption to selectively deplete ApoB-containing lipoproteins. FDA-approved for familial hypercholesterolemia refractory to statins.
04
Immunoadsorption
Protein A or antigen-specific column binds target IgG subclasses. Used for dilated cardiomyopathy, myasthenia gravis, and refractory autoimmune disease.
05
INUSpheresis®
Multi-column system targeting environmental xenobiotics, borrelia proteins, lipopolysaccharides, and metal–protein complexes with high specificity.
Membrane Filtration
06
DFPP (Cascade Filtration)
Two-stage membrane system: first separates plasma; second retains small proteins (albumin) while removing larger pathogenic molecules by molecular weight cut-off.
07
Cryofiltration
Plasma cooled to 4°C; cryoglobulins and immune complexes precipitate and are captured. Plasma rewarmed before return. Used in cryoglobulinemia and autoimmune vasculitis.
Volume Exchange
08
TPE / Plasmapheresis (PEX)
Removes 1–1.5 plasma volumes per session; replaces with albumin or FFP. Broad-spectrum clearance of inflammatory mediators; indicated in TTP, GBS, myasthenia crisis.
09
Young / Heterochronic Plasma
Infusion of screened allogeneic young donor plasma. Experimental longevity application based on parabiosis research. Regulatory status varies by jurisdiction.
Clinical Use Cases
Common Protocol Applications
Cardiovascular
LDL & Lp(a) Reduction
Bi-weekly LDL apheresis for FH or elevated Lp(a) refractory to PCSK9 inhibitors and statins. Achieves acute 60–75% reduction per session.
Autoimmune
Autoantibody Clearance
TPE or immunoadsorption for acute myasthenia, anti-NMDAR encephalitis, or TTP. Often 5 sessions over 10 days as first-line rescue therapy.
Longevity / Optimization
Environmental Detox
INUSpheresis® 2-session protocol for removal of bioaccumulated microplastics, PFAS, heavy metals, and LPS. Typically repeated quarterly.
Signaling
Ozone Redox Therapy
EBO2 / EBOO session targeting oxidative recalibration, lipid filtration, and oxygen saturation improvement. Popular in anti-ageing and chronic fatigue protocols.
Hematology
Cryoglobulin Removal
Cryofiltration or TPE for symptomatic cryoglobulinemia with vasculitis, neuropathy, or renal involvement. Adjunct to underlying disease treatment.
Experimental
Plasma Exchange for Aging
Neutral TPE or young plasma infusion protocol aiming to dilute pro-aging factors (TGF-β1, β2-microglobulin) and enrich rejuvenating circulating factors.
Risk & Contraindications
Safety Profile & Patient Selection
General Inclusion Criteria
- Confirmed diagnosis requiring extracorporeal clearance
- Stable haemodynamic status prior to session initiation
- Adequate peripheral or central venous access available
- Normal or corrected coagulation parameters
- Absence of active systemic infection or sepsis
- Informed consent obtained with risk disclosure
- Baseline labs: CBC, CMP, coagulation panel, disease markers
Contraindications & Adverse Events
- Haemodynamic instability or active cardiac arrhythmia
- Severe thrombocytopaenia (< 50 × 10⁹/L) — heparin circuits
- ACE inhibitor use during sessions (anaphylaxis risk with some columns)
- Known allergy to albumin or FFP replacement fluids
- Protein-losing nephropathy (accelerated depletion)
- Pregnancy — relative contraindication; case-by-case review
- Citrate sensitivity or ionised hypocalcaemia history (citrate anticoagulation)
Key Terminology
Clinical Glossary
Apheresis
Blood Component Separation
Procedure extracting specific blood components extracorporeally and returning the remainder to the patient.
DFPP
Double Filtration Plasmapheresis
Cascade filtration using two membranes of differing pore size for molecular-weight-selective plasma cleaning.
TPE
Therapeutic Plasma Exchange
Removal and replacement of full plasma volume with albumin or fresh frozen plasma to clear pathogenic factors.
NRF2
Nuclear Factor Erythroid 2–Related Factor 2
Master transcription factor regulating antioxidant and cytoprotective gene expression; activated by hormetic ozone stimulus.
GDF11
Growth Differentiation Factor 11
Circulating protein hypothesised to mediate rejuvenating effects observed in parabiosis studies; declines with age.
LPS
Lipopolysaccharide
Bacterial endotoxin component driving chronic systemic inflammation; target of INUSpheresis® columns.
FFP
Fresh Frozen Plasma
Donor plasma containing all coagulation factors; used as replacement fluid in TPE to restore clotting capacity.
Lp(a)
Lipoprotein(a)
Highly atherogenic lipoprotein variant; genetically determined and largely resistant to statin therapy — targeted by LDL apheresis.
EBOO
Extracorporeal Blood Ozonation & Oxygenation
Next-generation EBO2 incorporating higher ozone concentrations, larger blood volumes, and integrated filtration per session.
ApoB
Apolipoprotein B
Structural protein on all atherogenic lipoproteins (LDL, VLDL, IDL, Lp(a)); single best marker of cardiovascular particle burden.