US Doctor Lists Three Gaps in Kolonaki Clinic Case

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The death of Giorgos Mazonakis has drawn questions from patients and doctors about plasmapheresis. Dr Allen P. Green, a clinical pathologist and associate medical director at Global Apheresis in Mill Valley, California, who says he has run more than 500 procedures, answers them on his website.

Green writes that reports about the private Kolonaki clinic — if the courts confirm them — describe a setting that lacked three basics for any apheresis programme: staff trained for the method, working kit for emergencies, and clear rules to stop a session.

He first splits the terms. English reports often treat “plasmapheresis,” “plasma exchange” and “blood purification” as one thing. They are not.

INUSpheresis, the system used in Mazonakis’s case, is a form of double-filtration plasmapheresis (DFPP). A machine separates plasma from blood cells, sends the plasma through a second filter that holds larger molecules, then returns it. No replacement fluid is added.

Therapeutic plasma exchange (TPE), the method Green uses, removes plasma and replaces it with fresh albumin. Published safety data on INUSpheresis, he says, is thin — small observational papers from European centres.

He warns that buying a machine is not the same as knowing how to run it. “A clinic buys the machine, a sales rep trains the staff over the course of a weekend, and plasma exchange is added to the services provided.” “The term ‘longevity clinic’ is not a qualification, nor is ownership of an apheresis machine.”

On Mazonakis he offers two readings.

First: the session itself caused harm — wrong fluid, skipped lab tests, unsuitable kit, ignored alarms, or treating a patient who should not have been treated that day. He stresses the last point and, in the Greek report, points at physician Ioanna Gaka: new confusion, speech trouble, a new cough, unexplained fluid retention or an inability to stand should cancel the appointment and send the patient for urgent review. A unit that cannot cancel a booked session has a structural problem, not a clinical one.

Second: a cardiac event that would have happened anyway. Arrhythmias and heart attacks occur in offices and on treadmills. Timing during a procedure does not prove the machine caused it. In a proper unit, he says, staff spot the change in seconds, stop the circuit, start resuscitation with kit checked that morning, and call emergency services. The first minutes decide survival. The room does not decide whether an event happens; it decides whether the patient lives through it.

The Greek article adds that autopsy findings, as reported there, did not show a heart problem in Mazonakis. That claim belongs to the investigation, not to Green’s two general interpretations.

Green lists other risks of plasma-removal work: a drop in ionised calcium that can affect heart conduction; a sudden fall in blood pressure, especially if the patient is dehydrated, on blood-pressure drugs or already has heart disease; running the machine after alarms without finding the cause; no tests before treatment; and no certified staff, drugs or kit to call emergency services at once.

Source: Philenews, citing protothema.gr and Dr Allen P. Green’s website, 22 September 2026.

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