Greetings from the Desk of Journal Coordinator!

Extracorporeal membrane oxygenation (ECMO) has transformed from being a rare, last-resort support modality to a mainstream lifesustaining therapy in modern critical care.Over the past decade, and particularly in the years following the COVID-19 pandemic, ECMO programs have expanded rapidly across India and the South Asian region.What was once confined to select quaternary centers is now increasingly available in tertiary hospitals, with growing expertise among intensivists, anesthesiologists, perfusionists, surgeons, emergency physicians, and specialized nursing teams.As the Journal Coordinator of the Indian Journal of ECMO (IJECMO), it is both a privilege and a responsibility to witness this evolution and to help chronicle it through robust scientific communication.In India, the growth of ECMO has been particularly striking over the last 10-12 years.Dedicated ECMO teams, structured training programs, simulation-based education, and institutional protocols have driven a steady improvement in outcomes.Survival rates, complication profiles, and patient selection strategies increasingly mirror those from high-volume international centers.However, our patient demographics, disease burden, resource constraints, and transport challenges remain uniquely Indian.This makes locally generated evidence not only relevant but also essential.The IJECMO was envisioned as a platform to showcase this evolving experience, to capture our innovations and challenges, and to provide a voice to clinicians working in diverse practice environments.As ECMO continues to integrate into emergency care, trauma, transplantation, toxicology, and organ donation pathways, the role of an India-centric scientific journal becomes even more crucial.One of the most exciting developments in contemporary ECMO practice is its expanding scope of application.No longer limited to severe ARDS and cardiogenic shock, ECMO is now being increasingly utilized in newer clinical contexts, including toxicology, peri-transplant support, trauma, sepsis, and organ donation pathways.These emerging indications represent both opportunity and responsibility-opportunity to save lives in previously fatal scenarios, and responsibility to carefully document outcomes, complications, and ethical considerations.ECMO has emerged as a powerful tool in the peritransplant setting, both as a bridge to transplantation and as posttransplant support.In lung transplantation, ECMO is now widely used as a bridge for patients with end-stage respiratory failure who deteriorate while awaiting donor organs.It has also found an important role intraoperatively and in the immediate postoperative period for primary graft dysfunction.In heart transplantation, ECMO serves as both bridge-to-transplant in advanced cardiogenic shock and as rescue support for primary graft failure.Similarly, in liver transplantation, selected cases with severe portopulmonary hypertension, hepatopulmonary syndrome, or acute intraoperative cardiac failure have benefitted from temporary ECMO support.The Indian transplant ecosystem is developing rapidly, with increasing number of heart, lung, and liver transplants being performed each year.The integration of ECMO into this ecosystem has significantly expanded transplant eligibility and improved perioperative safety.However, transplant-related ECMO is complex, resource-intensive, and associated with unique complications such as bleeding, thrombosis, infection, and graft-related challenges.Careful selection, multidisciplinary coordination, and institutional preparedness are critical to success.We believe that India is entering a phase where transplant-ECMO data will grow exponentially.The IJECMO aims to be the primary repository for such experiences, providing insights into protocols, outcomes, complications, and long-term follow-up that will guide future practice.Another emerging and ethically sensitive application of ECMO is in the context of organ donation.In countries with advanced donation networks, ECMO-supported donation has significantly improved both the quantity and quality of retrieved organs.In India, where the organ donation rate remains far below demand, this represents a promising but challenging frontier.Legal frameworks, ethical oversight, public awareness, and institutional protocols must evolve in parallel to ensure transparency and trust.Scientific documentation of such experiences from Indian centers is invaluable-not only to demonstrate feasibility and outcomes, but also to guide policymakers and ethics committees.The IJECMO welcomes thoughtful submissions on ECMO in the context of organ donation, including ethical analyses, protocol development, and outcome studies.One of the most dramatic and logistically demanding aspects of ECMO practice is the transport of critically ill patients on extracorporeal support.ECMO transport allows patients in peripheral centers to be stabilized and transferred safely to high-volume ECMO hubs for definitive care.In a geographically vast and diverse country like India, this capability is nothing short of lifesaving.However, ECMO transport is inherently high risk.It involves moving the most unstable patients-often with refractory shock, severe hypoxemia, or ongoing bleeding-across long distances, sometimes over hundreds of kilometers, by road or air.The success of such missions depends on meticulous planning, experienced teams, robust equipment, and well-rehearsed protocols.As ECMO in India steps into a new era of expansion, innovation, and increasing complexity, the responsibility on the ECMO community to generate high-quality, ethically sound, and contextually relevant evidence has never been greater.The IJECMO remains committed to serving as a trusted academic platform that reflects real-world Indian practice-its successes, limitations, and ongoing evolution.We strongly encourage clinicians, perfusionists, nurses, and researchers to share their experiences, innovations, protocols,