In 2019, the American Society of Hemodialysis (ASFA) issued its 8th recommendation, significantly expanding the indication for TPE in many critical care conditions such as sepsis with multiple organ failure, acute liver failure, acute pancreatitis with hypertriglyceridemia, poisoning, etc. [52]. These conditions are mostly rare, so clinical trials evaluating the effectiveness of the indication are still modest. The differences in disease patterns lead to many centers having specific indications whose effectiveness has not yet been proven.