Two-Stage Approach to Intestinal and Multi Visceral Transplantation: Analysis of Pre-transplant Predictors and Post-transplant Outcomes

heart and lung transplantation, and providing rescue therapy for sepsis and post-transplant cardiorespiratory support.Methods: We analyzed three patients who underwent multi-visceral transplantation at the Miami Transplant Institute (2021-2024) with intraoperative veno-venous (VV) ECMO support.Outcomes included intraoperative blood loss, graft and patient survival, rejection rates, thromboembolic complications, and ICU length of stay (LOS).Results: VV ECMO provided improved intraoperative cardiorespiratory stability and significantly reduced blood loss.Graft and patient survival, rejection rates, and ICU LOS were comparable to non-ECMO cases.No thromboembolic events occurred Conclusions: VV ECMO offers critical pulmonary support during multi-visceral transplantation without compromising cardiac output.Its role in stabilizing hemodynamics and minimizing blood loss may reduce perioperative morbidity and mortality.Further studies are warranted to establish its routine use in high-risk patients.