FAQs

Therapeutic apheresis is extracorporeal blood filtration treatment in which blood is withdrawn from the body, separated into plasma and cellular components, the plasma is filtered or exchanged, and then returned to the patient.

What is removed depends on the type of apheresis being performed. Selective lipoprotein apheresis, for example, is designed primarily to reduce ApoB-containing lipoproteins such as LDL and Lp(a), while Therapeutic Plasma Exchange (TPE) removes and replaces the patient’s plasma more broadly.

Both types of treatments are considered apheresis, but they differ in what they remove and what happens to the patient’s plasma.

Selective LDL Apheresis, for example, is designed to remove LDL cholesterol, LP(a), and CRP, among others, while preserving other plasma components. Depending on the specific apheresis system used, additional circulating factors may also be reduced during treatment.

Therapeutic Plasma Exchange, or TPE, removes the patient’s plasma. The plasma is discarded, and the patient is given replacement fluid, with Albumin, a protein that our body naturally produces and functions as a critical transport vehicle in the plasma.

In simple terms, LDL Apheresis selectively filters targeted substances from the plasma, while TPE removes and replaces the plasma itself.

Dr. Isaac Eliaz pioneered the use of therapeutic apheresis for a multitude of new indications over the last 15 years and has expanded the use of apheresis on a global scale. This includes hands-on clinical apheresis at Amitabha Medical Clinic, development of new apheresis filters through Eliaz Therapeutics, and research and publications of key scientific papers in the field.

His approach emphasizes the strategic use of apheresis as part of a broader clinical protocol rather than as a one-size-fits-all procedure. Each treatment is individualized with proprietary supportive IV Therapy, based on patient’s unique medical history, extensive pre-screening labs, careful vascular access assessment, safety monitoring, and treatment sequencing.

Dr. Eliaz has also authored multiple peer-reviewed publications in the field of apheresis, including research on Galectin-3, inflammation, and selective removal strategies.

The potential role of therapeutic apheresis depends on the specific condition, the type of apheresis being used, and the individual patient’s clinical needs. Depending on the patient’s medical history, laboratory findings, and treatment goals, therapeutic apheresis may be considered as part of care for:

• Chronic or treatment-resistant elevations in LDL cholesterol or lipoprotein(a)
• Supportive and integrative care in selected patients  with cancer 
• Chronic infections or post-infectious inflammatory conditions
• Elevated environmental burden such as heavy metals or mold toxicity
• Certain autoimmune conditions
• Neurological or cognitive-related conditions
• Neuropathy and pain management
• Chronic kidney disorder (CKD)
• Complex inflammatory conditions
• Hyperviscosity-related issues
• Support metabolic health and longevity
• Metabolic health and other individualized clinical goals

The evidence, established indications, and type of apheresis used vary considerably by condition. A diagnosis alone does not mean that apheresis is appropriate, and each patient is evaluated individually before treatment is recommended.

Depending on the targeted objective and the patient’s needs, apheresis may help reduce substances circulating in the plasma, including inflammatory compounds, oxidized lipids, or damaged proteins, fibrinogen, LDL cholesterol, triglycerides, Lipoprotein(a), and certain toxin-bound or lipid-soluble toxins.

Different apheresis systems are designed to remove different substances, so the expected effect varies according to the treatment being used.

Galectin-3 is a naturally occuring protein that our bodies produce but when elevated, can often be associated with inflammation, fibrosis, immune signaling or dysregulation, and tissue remodeling. Dr. Eliaz’s work has focused extensively on Galectin-3 as a circulating mediator and key driver in acute and chronic inflammatory conditions, including sepsis in the ICU.

Additional preclinical research has explored Galectin-3 depletion apheresis in inflammatory models, supporting continued investigation into Galectin-3 as a therapeutic target. To learn more about Dr. Eliaz’s work with Galectic-3 in critical care, visit: Eliaz Therapeutics.

Possible side effects may include fatigue immediately following treatment, lightheadedness, temporary low blood pressure, tingling, mild discomfort at IV sites, bruising, bleeding at access sites, or rare allergic or histamine-type reactions. Other less common side effects may include nausea, sweating, diarrhea, or flu-like symptoms. A consultation is required for all new patients to review if apheresis is an appropriate treatment for you.

Yes. In integrative protocols, apheresis may be sequenced around other therapies such as supportive IV Therapy, regenerative therapies, oxidative therapies, oncology treatments, detoxification protocols, or antimicrobial strategies, when clinically appropriate.

Dr. Eliaz’s unique approach with apheresis integrates it into a broader, individualized treatment plan based on the patient’s clinical needs. Treatment sequencing should always be directed by a physician and coordinated with the patient’s broader medical team.

Aphereis treatments begins with establishing IV access and return access through each arm, respectively. Blood is slowly drawn from the body and circulated through an apheresis machine, where it is separated into blood cells and plasma. During Selective LDL Apheresis, the plasma passes through a specialized filter that binds selective inflammatory compounds. The filtered blood and plasma is then returned to the body.

During Therapeutic Plasma Exchange (TPE), the patient’s plasma is removed and the patient is given replacement fluid such as in the form of albumin. Supportive proprietary IV Therapy is often paired before, during, and after each treatment to ensure patient is properly hydrated and IV’s can help mobilize stored toxins that are often sequestered in the tissue to come up to the bloodstream.

To ensure a successful treatment, you can prepare for an apheresis treatment at least one week in advance with the following:

• Increase daily fluids and proper hydration, especially 72 hours prior (be careful to not overly increase hydration on the day of to avoid too many restroom breaks)
• Eat a well-balanced meal the night before and the morning of, prior to treatment
• Take medications only as directed by the treating physician
• Avoid blood thinners or ACE inhibitors for up to 2 weeks prior, or as instructed
• Wear comfortable clothing
• Avoid any physically strenuous activity immediately after
• Pack any preferred snacks or a meal to have on hand during treatment

Eliaz Apheresis uses an individual, integrated approach that is unique for each patient and their medical history. There is no single program that is right for everyone. The number and frequency of treatments, along with any paired supportive IV Therapy, depend on:

• Your diagnosis and overall health
• The type of apheresis being performed
• Treatment goals or health objectives
• Laboratory findings
• Tolerance and response to treatment
• Whether apheresis is being coordinated with other therapies

Some patients may expect to have at least two minimum treatments to start, to be completed within a concentrated window of time. Your initial program may be adjusted based on your clinical response and follow-up testing.

A typical apheresis treatment lasts approximately four to five hours, although the total time may vary based on the specifics of your individualized treatment program, vascular access, total plasma volume being treated, and individual tolerance.

We encourage patients to fully relax during treatment, you may listen to an audiobook or podcast, read, rest, or use the time quietly, keeping in mind that movement of the arms may be limited. Temporary effects can include: feeling cold, fatigue, tingling around the lips or fingers, mild nausea or lightheadedness, muscle cramping, changes in blood pressure, or bruising or discomfort at the IV site. Our clinical team will monitor you closely and may provide fluids, calcium, magnesium, or other supportive measures when medically appropriate.

Some patients feel fatigue after treatment, so we recommend limited any physical activity and getting a full night. Other possible side effects may include fatigue immediately following treatment, some lightheadedness, temporary low blood pressure, tingling, mild discomfort at IV sites, bruising, bleeding at access sites, or rare allergic or histamine-type reactions. Less common but other potential side effects may include a deeper detoxifying reaction such as nausea, sweating, diarrhea, or flu-like symptoms. We will review any potential side effects at the time of scheduling.

ACE inhibitors require special attention because they may increase the risk of bradykinin-type reactions during treatment. If you are taking ACE inhibitors or other forms of blood thinning medications or supplements, you may be instructed to stop taking them for at least one week, or up to two weeks prior.

Therapeutic apheresis may be beneficial for patients with complex inflammatory, metabolic, cardiovascular, neurological, autoimmune conditions, and as a broader integrative cancer care plan, or other chronic health concerns. For patients  who have not achieved adequate improvement through other treatments alone, we encourage you to explore if Eliaz Apheresis is right for you.

Eligibility and screening is determined on an individual basis. A diagnosis alone does not automatically mean that therapeutic apheresis is appropriate for you.

A good candidate must also be able to tolerate temporary changes in circulating fluid volume and have suitable vascular access, including alternative forms of access such as through a compatible port, IV catheter, or midline. Before treatment is recommended, we will review your:

• Medical history and current diagnoses
• Medications and supplements
• Laboratory results
• Cardiovascular and kidney function
• Bleeding and clotting risk
• Previous reactions to infusions or blood-processing procedures
• Current and planned treatments

If you don’t have the best veins or have a history of difficulty with vein access, eligibility will be evaluated on a case by case basis. In some cases, a central venous catheter or another type of access such as via a midline or compatible port may be considered. Any potential additional risks or side effects require careful medical review. We can help assess your veins before confirming whether you can safely proceed with treatment.

Therapeutic apheresis may be coordinated in conjunction with chemotherapy, radiation, surgery, immunotherapy, or other supportive treatments. Within an integrative oncology plan, aphereis may be used to support and optimize other cancer treatments, along with reducing circulating inflammatory compounds and clearing blocked detox pathways, improving overall circulation, or helping prepare the patient for or recover from other therapies.

Therapeutic apheresis is being explored for selected patients with Long COVID, particularly when symptoms appear to involve persistent inflammation, immune dysregulation, abnormal clotting or blood-flow patterns, autoantibodies, or elevated circulating inflammatory substances. However, Long COVID is complex, and a detailed medical evaluation during your initial consultation is needed to determine whether your symptoms, laboratory findings, and treatment history suggest that apheresis may be appropriate.

Please ask your referring provider to send your referral, any recent medical records, relevant laboratory results, current medication list, and a brief summary of your diagnosis and treatment goals Amitabha Medical Clinic by faxing 707-542-5955. Once the records are received, our team will review them and contact you regarding the next steps. Additional testing or a consultation may be required before treatment can be approved or scheduled.

Eliaz Apheresis currently only considers patients under 18 on a case-by-case basis. A parent or legal guardian must participate in the consultation and consent process.

Any possible insurance coverage or reimbursement will vary. Eliaz Apheresis is not within any insurance network. Payment is rendered in full at the time of service and an additional deposit may be required at the time of scheduling. Patients should contact their insurance company directly to confirm any potential benefits or possible coverage before scheduling treatment.

The first step is to complete our Pre-Screening Questionnaire. You may also contact our New Patient Care Team directly and request an initial consultation. We will ask you to provide:

• A brief description of your diagnosis, symptoms, and treatment goals
• Recent medical records and laboratory results
• A current medication and supplement list
• Information about previous and ongoing treatments
• Your referring provider’s information, if applicable

We will review your medical history and help determine whether an apheresis consultation is appropriate. During the consultation, our providers will discuss which type of apheresis may be considered, potential benefits and limitations, safety considerations, potential treatment frequency, vascular-access requirements, and estimated costs. Submitting an inquiry or referral does not guarantee eligibility. Treatment is recommended only after an individualized medical review.

Some sensitive or chemically sensitive patients may tolerate apheresis well if apheresis treatment is appropriate for them. Please let us know if you have a history of sensitivity when completing our Pre-Screening Questionnaire.