Comparing routine and on-demand ECMO support during lung transplant surgery
Compares always using ECMO with using it only when needed in lung transplant patients.
Plain-language title generated from the registry record
Registry title: Routine vs On-demand ECMO for Lung Transplantation
Key facts
- Where
- Edmonton, Montreal, Toronto, and Vancouver, CanadaSee the 4 sites
Where in Canada
- Univeristy of Alberta & Alberta Health ServicesEdmonton, CanadaNot yet recruiting
- Centre Hospitalier de l'Université de MontréalMontreal, CanadaTaking people
- University Health Network / Toronto General HospiatlToronto, CanadaNot yet recruiting
- Vancouver General HospitalVancouver, CanadaNot yet recruiting
Questions to ask the study team
- How often do I need to come in, and for how long each time?
- Are travel costs paid?
- Can I keep my own doctor?
- What happens if I want to stop?
Trial details
- Who runs it
- Centre hospitalier de l'Université de Montréal (CHUM)
- Trial code
- NCT06615492
- Record updated
- 23 December 2025
- Original description
Lung transplantation is a complex procedure performed in patients with terminal lung disease. The transplant procedure stresses the patient's heart and lungs, which are already taxed by the underlying disease process. The heart-lung machine is occasionally used to support the patient and ensure adequate oxygen supply to other organs during the operation. It can be used routinely in all patients or selectively in patients who exhibit reduced oxygen supply to the remaining organs. This process, known as cardiopulmonary bypass (CPB), pumps blood out of the body to a heart-lung machine that removes carbon dioxide and returns oxygen-filled blood to the body.Read full original descriptionShow less
RoutinE Versus On-demand Intraoperative Extracorporeal Membrane Oxygenation (ECMO) During LUng TransplantatION (REVOLUTION)
Lung transplantation is a complex procedure performed in patients with terminal lung disease. The transplant procedure stresses the patient's heart and lungs, which are already taxed by the underlying disease process. The heart-lung machine is occasionally used to support the patient and ensure adequate oxygen supply to other organs during the operation. It can be used routinely in all patients or selectively in patients who exhibit reduced oxygen supply to the remaining organs. This process, known as cardiopulmonary bypass (CPB), pumps blood out of the body to a heart-lung machine that removes carbon dioxide and returns oxygen-filled blood to the body.
Although using the CPB increases the risk of bleeding, infection, and coagulation complications, it should still be considered in high-risk patients to compensate for more severe complications such as kidney failure and stroke caused by a lack of cardiopulmonary support. Extracorporeal membrane oxygenation (ECMO) is a recently developed CPB variation associated with fewer bleeding complications. It has recently replaced the traditional heart-lung machine as the preferred method of cardiopulmonary support during lung transplantation. Since ECMO is associated with fewer complications than standard CPB, many centers have increased their use of ECMO during lung transplantation. Some have even employed it routinely. However, there remains significant debate on how often it should be used.
Therefore, the study's main objective is to compare the two approaches in lung transplantation, i.e., routine use versus selective use, and to determine if one approach is preferable to the other.
Inclusion: Patients undergoing lung transplant surgery.
Exclusion: Multi-organ transplantation; Lung transplant recipients where intraoperative cardiopulmonary support is mandatory:; Patients requiring concomitant cardiac surgery: For example, significant coronary artery disease (CAD) requiring surgical grafting; Severe pulmonary hypertension (PH):; Systolic pulmonary artery pressure (PAP) ≥ 80 mm Hg on the most recent echocardiography, right heart catheterization, or pulmonary artery catheter measurement; Mean PAP ≥ 55 mm Hg on the most recent echocardiography, right heart catheterization, or pulmonary artery catheter measurement; The ratio of mean pulmonary to systemic artery pressure of \> 0.66; Left ventricular dysfunction: Defined as ejection fraction (LVEF) less than 45% on echocardiography, ventriculography, computed tomography (CT), or magnetic resonance imaging (MRI); Inability to provide consent for the study; Retransplantation; Contra-indication to standard heparin anticoagulation (e.g., heparin-induced thrombocytopenia); Moderate to severe right ventricular (RV) hypokinesis or dysfunction.