The tree · Inflammation and the body's messaging
Replacing the liquid part of a person's blood slows an age-related disease
If old blood carries signals that hold the body back, then taking out the liquid part (the plasma) and replacing it with salt water and a blood protein should help, and in 2020 a Berkeley group showed that it did in old mice: one such exchange improved their muscle repair, liver and brain. The procedure, plasma exchange, has been used in hospitals for decades for other reasons. In people the record so far is a 2020 Spanish and American trial of 347 people with Alzheimer's disease (322 of them treated and followed), in which those given monthly plasma exchange for over a year declined more slowly on tests of daily function than those given a sham procedure. It is a first human on an age-related disease, with the caution that the trial had several measures and not all moved.
What would count
A controlled trial in people reports that replacing or diluting the plasma slows the course of an age-related disease, or improves an age-related function, more than a sham procedure on a pre-stated main measure, in a peer-reviewed report. The animal rung is the same in a living animal. For the clinic rung: a regulator approves plasma exchange or dilution for an age-related condition, or a named clinical setting gives it for that purpose in routine care and publishes that practice.
Who settles it: The peer-reviewed trial report; the regulator's approval record, or a named clinical setting's published practice, for the clinic rung.
Where it stands
First human. Reached 27 July 2020, on the record of doi.org. Next rung within 5 to 20 years.
When it reaches the clinic: the project's estimate
This is the one thing on this page that is a judgment rather than a record. The project's estimate of the year it reaches the clinic is 2038, no earlier than 2030 and no later than 2075; the model draws from that range every run, with the likely year the most probable draw. Set 16 October 2026, a first pass awaiting an outside review.
| Rung | No earlier than | Most likely | No later than | |
|---|---|---|---|---|
| In clinical use | 2030 | 2038 | 2075 | feeds the year at the top |
Why. The procedure is cheap to trial because it exists; the likely year assumes a controlled trial in healthy older adults with a function or a clock as its main measure reports positive in the early 2030s and a named service or regulator adopts it for ageing later that decade. The earliest assumes the Alzheimer's result wins a label line within a few years; the latest allows for the 2020 result not replicating and the procedure staying a private-clinic offer.
Changes to this record
- 17 October 2026, notes: (nothing; text added at the end of the notes) became FOR JOHN, added 2026-10-17 from the weekly reading of that date: the case for the clinic rung. The test accepts a named clinical setting that gives the treatment for that purpose in routine care and publishes that practice. On 2026-03-12 the supplier Grifols announced (grifols-2026) that the Ace Alzheimer Center in Barcelona has run its plasma-exchange-with-albumin programme (AMBAR) for people with Alzheimer's disease since 2021, that new clinics are opening in hospitals in Madrid, Mallorca and Alicante, that more than 5,000 exchanges have been done, and that the protocol is in the guidelines of the American Society for Apheresis. On a plain reading that could be the clinic rung from 2021 or 2026-03-12. It was not moved because the source is the supplier's release and not the clinical setting's own publication of its practice, the apheresis society's category for Alzheimer's disease was not seen, and a stage never moves down, so a mistake here could not be undone. Whether a company-run clinic programme counts as routine care, and whether the clinic rung's test should be widened to say so, is John's call. If it counts, the entry moves to in clinical use and its estimate (earliest 2030) must be rewritten. This entry stays at first human.. [reading 2026-10-17] Writes the case for the clinic rung into the notes with its source and leaves it for John, as ruled; the stage did not move. Source: S.A., 12 March 2026.
The last readings
- 17 October 2026 Left for the author
Nothing in the window: no new controlled trial, regulator's record or published clinical practice dated 2026-10-10 to 2026-10-17 was found. Two older items the leaf does not mention bear on the clinic rung. On 2026-03-12 Grifols announced that it and Ace Alzheimer Center Barcelona had renewed their agreement to run the AMBAR programme at that centre, that AMBAR Clinic centres were being added in Madrid, Mallorca and Alicante, that more than 5,000 plasma exchanges with albumin had been performed, and that the protocol is included in the guidelines of the American Society for Apheresis. In 2026-06 Circulate Health announced a partnership under which Reborne would become the first UK hospital to offer its plasma-exchange protocols, which is a private commercial offer and not the kind of record the settler names. Left for the author: The clinic rung's test is met by "a named clinical setting gives it for that purpose in routine care and publishes that practice". The 2026-03-12 Grifols release says a named centre in Barcelona gives plasma exchange with albumin to people with Alzheimer's disease as a clinical programme, with more than 5,000 exchanges done and new centres opening, and that an apheresis society's guideline lists the protocol. On a plain reading that could be the clinic rung, which would move the leaf from first-human to in-clinical-use with 2026-03-12 or an earlier date, and would bring the estimate's earliest year of 2030 forward. I would not move it myself: it is a company release and not a publication of the practice by the clinical setting itself, I could not open the release to check its wording, the apheresis guideline's category for Alzheimer's disease was not seen, and the date is before the window. Whether a company-run clinic programme counts as routine care for the test, and whether the settler needs widening to say so, is the author's call. To log in the publications log once its page has been read, as the reading's rule asks: Grifols and Ace Alzheimer Center Barcelona renew their collaboration to drive the AMBAR programme and add new centres (Company press release, 2026-03-12; https://www.grifols.com/en/view-news/-/news/grifols-y-ace-alzheimer-center-barcelona-renuevan-su-colaboracion-para-impulsar-el-programa-ambar-e-incorporar-nuevos-centros).source 1, source 2, source 3
What the story so far says about it
On the record
- 30 May 2020Rejuvenation of three germ layers tissues by exchanging old blood plasma with saline-albumin
- 12 March 2026Grifols and Ace Alzheimer Center Barcelona renew their collaboration to promote the AMBAR clinical program and incorporate new centers
Notes
The animal result came after the human trial started, which is why the earlier-stage date is later than one might expect; the ladder records when each rung was reached, not the order a reader expects. The procedure already exists in every large hospital, so the clinic rung here is about a regulator or a named service deciding it is for ageing, not about building anything new. A small placebo-controlled trial in 42 healthy adults over 50, from the Buck Institute and a plasma-exchange company (Aging Cell, online 2025-05-27; posted first as a preprint on 2024-08-08), reported younger readings than placebo on 15 age clocks (estimates of biological age read from the chemical marks on DNA); its main aims were safety and those clocks. FOR JOHN, added 2026-10-17 from the weekly reading of that date: the case for the clinic rung. The test accepts a named clinical setting that gives the treatment for that purpose in routine care and publishes that practice. On 2026-03-12 the supplier Grifols announced (grifols-2026) that the Ace Alzheimer Center in Barcelona has run its plasma-exchange-with-albumin programme (AMBAR) for people with Alzheimer's disease since 2021, that new clinics are opening in hospitals in Madrid, Mallorca and Alicante, that more than 5,000 exchanges have been done, and that the protocol is in the guidelines of the American Society for Apheresis. On a plain reading that could be the clinic rung from 2021 or 2026-03-12. It was not moved because the source is the supplier's release and not the clinical setting's own publication of its practice, the apheresis society's category for Alzheimer's disease was not seen, and a stage never moves down, so a mistake here could not be undone. Whether a company-run clinic programme counts as routine care, and whether the clinic rung's test should be widened to say so, is John's call. If it counts, the entry moves to in clinical use and its estimate (earliest 2030) must be rewritten. This entry stays at first human.