Innovative Use of VV ECMO in patients undergoing Multivisceral Transplant for Cirrhotic patients with Portomesenteric Thrombosis

Background: Multi-visceral transplantation is an intricate and demanding surgical endeavor, posing significant challenges due to its complexity and the profound physiological derangements it induces. Patients with portomesenteric thrombosis and cirrhosis often develop extensive varices, extending from the skin to the retroperitoneum due to long-standing portal hypertension and collateralization. This makes surgery exceedingly challenging, with hemodynamic compromise occurring as early as the skin incision, necessitating massive transfusion protocols and multiple pressors.