Frequently asked questions

General Questions

Unfortunately, due to the high workload, medical inquiries regarding diagnoses and therapies cannot be personally answered by Dr. Trapp. However, Dr. Trapp will be consulted in every case for specific questions. In some instances, appointments for discussing findings can also be scheduled over the phone. 

Please cancel appointments in a timely manner so that the slot can be offered to another patient. Kindly call the practice at least 48 hours in advance or send us an email to cancel appointments. If an appointment is canceled last minute without a valid reason or not canceled at all, a fee for missed appointments will be charged. 

No, the Center for Therapeutic Apheresis does not have statutory health insurance approval. This means that we cannot bill statutory health insurances and will issue a private medical invoice. 

Our goal is to maximize the benefit for your health. Some additional services are not covered by either private or statutory health insurances. This does not mean that therapeutic measures lack medical indication, but rather that health insurances have not included them in their service catalogs due to outdated economic considerations. However, prior to the planned therapy, you will be informed about all costs and billing options. Further information can be found in the “Billing” section of the FAQs. 

Waiting times typically range from 3 to 4 weeks. For more accurate information, please feel free to contact us by phone at any time. 

If we have received all your documents regarding your medical history, as well as the necessary completed forms and agreements, Dr. Trapp can conduct the consultation over the phone if necessary. However, you still need to present yourself in person at least one day before the scheduled apheresis so that Dr. Trapp can assess your veins. If your vein condition is more complex, an anesthesiologist will be consulted for the treatment. 

The environmental medicine initial consultation involves a comprehensive medical history review and typically lasts between 1 to 1.5 hours. Dr. Trapp will review your previous diagnoses, lab results, and findings, and discuss the next steps with you in detail. Additionally, he will examine your veins in the elbow creases to determine their suitability for apheresis. If they are not suitable, you will be informed about the next steps with our anesthesiologist. 

Questions about Apheresis

The answer to this question is explained in detail “here”

Toxopherese® is a trademarked term that refers to a specific apheresis procedure. It combines established methods to ensure the best possible treatment. Only selected and specially trained partners are authorized to offer treatments under this name. 

The initial environmental medicine consultation typically lasts 1 to 1.5 hours and involves a thorough medical history review. Dr. Trapp will examine your existing diagnoses, laboratory results, and findings, discussing the next steps with you. Additionally, he will assess the veins in your arms to determine if they are suitable for apheresis. If they are not suitable, our anesthesiologist will inform you about the further process.

Ideally, you should use the restroom before the treatment begins. If necessary, our trained staff will assist you with a bedpan or urinal. You can eat a light meal and have some water before the apheresis. During the procedure, if you feel thirsty, we’ll gladly offer you a glass of water with a straw, as you won’t be able to move your arms.

Medical side effects occur in less than 0.4% of cases and are documented as mild blood pressure drops or post-puncture bleeding. Allergic reactions are extremely rare.

Even individuals with allergies can be treated without difficulty.

Further information on side effects: 

Dizziness and blood pressure drop: All tubing systems of the device are pre-filled with saline solution to compensate for volume shifts at a ratio of 1:1. As a result, blood pressure drops, dizziness, and heart rhythm disturbances are rare events (less than 1 in 1000). Additionally, blood pressure is continuously monitored.

Formation of a bruise at the puncture sites: Especially in cases of poor vascular conditions (e.g., diabetes), bruising may occur.

Post-puncture bleeding: To prevent post-puncture bleeding, the needles are removed by the doctor or trained staff, and a properly applied dressing is used.

Allergic reaction to the blood-thinning agent Heparin: If you notice redness of the skin or itching after the treatment, please contact Dr. Trapp immediately. Typically, these reactions subside after a few hours. However, your information may be important for optimizing future treatment.

On average, the treatment, including preparation, lasts about 3 hours, with an additional resting period of approximately 30 minutes. Therefore, please allocate 4 hours for your apheresis session.

The Therapeutic Apheresis with Toxopherese® is a double-membrane filtration apheresis. The procedure itself has been used as a treatment method in medicine worldwide for 25 years.

In Therapeutic Apheresis with Toxopherese®, specially adapted equipment and a filter system tailored to your specific situation are used. The key is that the blood plasma is relieved of pathological factors using this special filter. The percentage of relief is individual.

A special function of the AferSmart device is “hemoperfusion,” which has been shown by studies to remove some bacteria and viruses as well as their components and messengers from the patient’s blood using a so-called “Seraph adsorber” (a special filter made in the USA). A special adsorption cartridge is used for this purpose, which is capable of directly removing specific molecules responsible for the development of certain pathologies from the blood. This procedure is not performed with blood plasma but with whole blood. This treatment can be performed in a separate session or concurrently/ simultaneously with the apheresis described above.

Hemoperfusion can be used for certain infections with viruses (e.g., EBV, CMV, other herpesviruses).

Studies are currently being conducted in the USA with acutely ill COVID-19 patients, as well as patients with Long COVID and Post-COVID symptoms. Some studies are not yet complete. Neither we nor the manufacturers provide guarantees of success or promises of healing.

The reduction of certain bacteria (e.g., Borrelia and co-infections, streptococci, staphylococci, chlamydia, mycoplasmas, among others) has also been demonstrated.

In this variant of Therapeutic Apheresis, there is no plasma filtration, meaning no endogenous plasma is filtered or removed. The procedure is also not a (hemo-)dialysis.

It is possible that toxins from the tissues move into the parallel connected lymphatic system and circulate there until they are removed by further apheresis treatments (redistribution processes).

The need for Heparin is extremely low, and the amount is specifically calculated for your body. Heparin prevents blood clotting in the blood volume located outside the body, within the filter system (approximately 250-300 ml).

Before the apheresis procedure, alongside the documents from the initial consultation, we require a basic blood count and a recent EKG from you. These tests can be conducted on-site with prior scheduling. Alternatively, you may bring the results of the recent blood count or EKG from your primary care physician.

After the treatment, it’s essential to observe a rest period of at least 30 minutes. Feel free to relax in our waiting area, have a drink, and eat something. It’s advisable not to drive home alone by car, bicycle, or scooter. Please arrange for someone to accompany you or use a taxi service. Also, avoid engaging in physical activities (sports, work) immediately after the treatment.

The number of treatments always depends on the severity of the current clinical condition, the duration of the illness, and the previous treatment. The exact number of treatments will be determined by Dr. Trapp during the initial consultation with you.


During the initial phase, typically 2-3 treatments are planned. However, depending on the medical condition and severity, a larger number of additional apheresis sessions may be necessary over several years. On average, 6-12 apheresis sessions are required to achieve a clinically stable condition in the patient, leading to regeneration and recovery. After the initial phase of 2-3 apheresis sessions, the intervals between further treatments increase from 14 days to 4-8 weeks.

As every body is unique and disease patterns develop individually, no blanket answer can be provided for this question. While we have achieved good results with many patients, we do not offer guarantees of success or promises of healing. Treatment is only administered upon your explicit request after you have been thoroughly informed about the application, costs, risks, and side effects.

The term “H.E.L.P. Apheresis” (known from television reports) refers to a specific lipoprotein apheresis procedure by the company “B. Braun.” This form is a component of our Therapeutic Apheresis.

Toxopheresis® removes not only toxic metals but also fat-soluble environmental toxins (PCBs, DDE, benzene, solvents), inflammatory mediators (interleukins, cytokines), or circulating immune complexes from the body (eluate). Subsequently, these can be analyzed and detected in the laboratory. 

Please arrange for someone to pick you up or accompany you on the day of the treatment because you should not actively participate in traffic for the next 24 hours. We are also happy to provide you with a certificate of incapacity for work for this period.

Billing Inquiries

The current cost for a single apheresis treatment is approximately 2800 euros. The material cost alone for the filters is currently around 1300.00 euros.

Additional costs may arise for laboratory analyses. Blood, urine, stool, or eluate are examined as part of the apheresis procedure. Dr. Trapp will discuss with you during the initial consultation which examinations are advisable. You can also determine the approximate costs for these analyses during the initial consultation.

If your veins are not suitable for the apheresis cannulas, an anesthesiologist may use an ultrasound device to puncture the groin veins (insertion of a groin catheter). The services of the anesthesiologist are billed separately. The amount usually ranges from 300 to 500 euros.

In most cases, both public and private health insurance companies do NOT reimburse the procedure, making it primarily a self-pay service. According to health insurance companies, apheresis is often deemed “medically unnecessary.” However, we are always available to assist you in corresponding with your insurance company. Some private health insurance companies may offer partial reimbursements if diagnoses and findings are provided, and previous therapies have been unsuccessful. It is advisable to inquire about coverage with your insurance company beforehand to determine if any costs will be covered under specific conditions. 

Please note that no guarantees of success or promises of healing are made. Treatment is explicitly provided at the patient’s request.