Comparing blood transfusion thresholds in patients on ECMO
Official title: Restrictive Versus Liberal Thresholds for Red Blood Cell Transfusion in ExtraCorporeal Membrane Oxygenation - the TREC Study
Run by Academisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA) · NCT06560164 · Data updated 2026-11-12
This study tests whether giving fewer blood transfusions is safe and effective for adults on ECMO compared to giving more transfusions.
Quick facts
| Study type | Interventional |
|---|---|
| Ages | 18 Years and up |
| Sex | All |
| Enrollment | 526 (estimated) |
| Sponsor | Academisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA) Academic / other |
| Locations | 14 sites (Vienna, State of Vienna and 13 other locations) |
| Status | Recruiting |
| Started | November 26, 2024 |
| Main results expected | October 1, 2027 |
| Study ends | October 1, 2028 |
| Registry record updated | August 14, 2026 |
| Trial ID | NCT06560164 on ClinicalTrials.gov |
Is this trial a fit for you?
✓Likely a good fit
Ideal candidates for this study are adults aged 18 and older who are currently receiving ECMO support.
✕Probably not a fit
Patients who are not expected to survive for 24 hours or those who cannot receive blood products will not benefit from this study.
A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.
What this trial studies
This study investigates the safety and efficacy of restrictive versus liberal thresholds for red blood cell transfusion in patients undergoing extracorporeal membrane oxygenation (ECMO). The research aims to determine whether a restrictive transfusion strategy can be safely applied to this vulnerable population, which often experiences anemia and requires transfusions. By comparing outcomes between the two approaches, the study seeks to provide evidence-based guidelines for transfusion practices in ECMO patients. The study will involve patients aged 18 and older who are currently receiving ECMO support.
Why it matters
Potential benefit: If successful, this study could lead to improved transfusion practices, reducing unnecessary blood transfusions and associated risks for patients on ECMO.
How similar studies have gone: Previous studies in critically ill populations have shown that restrictive transfusion strategies can be non-inferior to liberal ones, suggesting potential success for this approach in ECMO patients.
Who can join: the full rules
Show full inclusion / exclusion criteria
Inclusion Criteria: * Patient is aged 18 years or older; * Is receiving ECMO; * (Deferred) informed consent. Exclusion Criteria: * Not expected to survive for 24 hours when assessed; * Inability to receive blood products; * (Known) decline to blood transfusions (e.g., Jehovah's Witnesses); * Extracorporeal carbon dioxide removal (ECCO2R) using low blood flow devices or pumpless devices (i.e., MINILUNG ®, PrismaLung+); * Received ECMO over 48h before screening for eligibility.
Where it's running
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MedUni Wien
Vienna, State of Vienna, Austria Recruiting -
Hôpital Erasme
Brussels, Brussels Capital, Belgium Recruiting -
KU Leuven, medical IC
Leuven, Flemish Brabant, Belgium Recruiting -
KU Leuven, surgical IC
Leuven, Flemish Brabant, Belgium Recruiting -
CHU Charleroi
Charleroi, Hainaut, Belgium Recruiting -
Medisch Spectrum Twente (MST)
Enschede, Drenthe, Netherlands Recruiting
Show 8 more locations
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Maastricht Universitair Medisch Centrum+ (MUMC+)
Maastricht, Limburg, Netherlands Recruiting -
Amsterdam UMC, location AMC
Amsterdam, North Holland, Netherlands Recruiting -
Universitair Medisch Centrum Groningen (UMCG)
Groningen, Provincie Groningen, Netherlands Recruiting -
Leids Universitair Medisch Centrum (LUMC)
Leiden, South Holland, Netherlands Recruiting -
Erasmus MC
Rotterdam, South Holland, Netherlands Recruiting -
St. Antonius Ziekenhuis
Nieuwegein, Utrecht, Netherlands Recruiting -
Karolinska Universtiy Hospital
Stockholm, Stockholm County, Sweden Recruiting -
Radboudumc
Nijmegen, Gelderland, Netherlands Not yet recruiting
Study contacts
- Principal investigator: Alexander P.J. Vlaar, PhD — Amsterdam UMC, location AMC
- Study coordinator: Alexander P.J. Vlaar, PhD
- Email: a.p.vlaar@amsterdamumc.nl
- Phone: 020 566 9111
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How to take part
- Review the eligibility criteria above with your treating physician.
- Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
- Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.