Therapeutic Plasma Exchange (TPE)

Therapeutic plasma exchange (TPE) at Liondale Medical removes aging blood plasma via an apheresis machine and replaces it with fresh albumin solution — effectively diluting circulating inflammatory proteins, senescent factors, and accumulated metabolic byproducts. Industry pricing runs $8,000–$10,000+ per session. A 2025 randomized controlled trial found TPE reduced biological age by 1.32 years per session. Each session runs 2–3 hours under physician supervision at the Upper West Side clinic.

Therapeutic plasma exchange (TPE) at Liondale Medical is one of the most clinically substantiated and technically complex longevity interventions currently available in private clinical practice in New York City. The procedure uses an apheresis machine — a device that separates blood components by centrifugation or membrane filtration — to continuously withdraw blood from the patient, remove the liquid plasma fraction, and return the cellular components (red blood cells, white blood cells, platelets) to the patient combined with a replacement fluid consisting of albumin solution. By removing plasma and replacing it with purified albumin, TPE effectively removes from circulation the full inventory of soluble plasma proteins, inflammatory mediators, senescent secretory factors (components of the senescence-associated secretory phenotype, or SASP), accumulated metabolic byproducts, autoantibodies, and other circulating factors that accumulate in plasma with age and are believed by some researchers to contribute to systemic aging processes. The interest in TPE as a longevity intervention was catalyzed by research from Tony Wyss-Coray's laboratory at Stanford demonstrating in parabiosis models that old blood factors have a negative effect on tissue function, and young blood factors have a rejuvenating effect. A 2025 randomized controlled trial (cited on Liondale Medical's website) measured epigenetic biological age changes following TPE and found an average reduction of 1.32 biological years per session (TPE alone) and 2.61 years when TPE was combined with IVIG (intravenous immunoglobulin). Liondale Medical monitors patients' inflammatory biomarkers and epigenetic status before and after TPE series, including CRP, IL-6, fibrinogen, metabolic panel, lipid panel, and epigenetic biomarker assessments, to track individual response. The procedure requires two IV access lines and a certified apheresis nurse alongside physician supervision. Sessions run 2–3 hours. An initial series of 3–6 sessions is typically recommended, followed by monthly or quarterly maintenance. Industry pricing runs $8,000–$10,000+ per session; Liondale-specific pricing is discussed at consultation. TPE is positioned as a premium intervention for patients committed to proactive biological age reduction.