LMWH versus UFH for ECMO anticoagulation during bilateral lung transplant

Is this trial a fit for you?

A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.

What this trial studies

This is a prospective observational pilot comparing perioperative anticoagulation strategies in adults undergoing bilateral lung transplantation with veno-arterial ECMO support. Patients receive either standard unfractionated heparin (UFH) or enoxaparin-based low-molecular-weight heparin (LMWH) as determined by the treating team, with anticoagulation monitored using ROTEM. The study records perioperative blood loss, hemoglobin, transfusion requirements, and thrombotic events, and performs detailed coagulation testing including point-of-care assays and thrombin generation tests. Results will be used to inform whether LMWH is a viable alternative to UFH in this setting and to design larger comparative trials if promising.

Why it matters

Who can join: the full rules

Inclusion Criteria:

1. ⃣ Adults (≥18 years old).
2. ⃣ Patients undergoing bilateral lung transplantation with perioperative veno-arterial (V-A) ECMO support.
3. ⃣ Planned perioperative anticoagulation with either UFH or LMWH, as determined by the attending anesthesiologist.
4. ⃣ Ability to provide informed consent or consent provided by a legally authorized representative.

Exclusion Criteria:

1. ⃣ Patients receiving ECMO as a bridge to lung transplantation.
2. ⃣ Patients requiring postoperative continuation of ECMO.
3. ⃣ Patients with perioperative blood loss ≥3,000 mL.
4. ⃣ Patients undergoing lung re-transplantation.
5. ⃣ History of severe coagulopathy or bleeding disorder.
6. ⃣ Active use of antiplatelet or anticoagulant therapy (excluding study anticoagulants).
7. ⃣ Known heparin-induced thrombocytopenia (HIT).
8. ⃣ Severe liver dysfunction (Child-Pugh C) or end-stage renal disease requiring dialysis.
9. ⃣ Pregnant or breastfeeding women.

Where it's running

• University Hospital Motol, 2nd Faculty of Medicine, Charles University in Prague and 3rd Department of Surgery, First Faculty of Medicine, Charles University, and Motol University Hospital, Lung Transplant Program
  Prague, Czech Republic, Czechia Recruiting

Study contacts

• Study coordinator: Miroslav Durila, prof. M.D., Ph.D., MHA
• Email: miroslav.durila@fnmoto.cz
• Phone: +420224435440

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How to take part

1. Review the eligibility criteria above with your treating physician.
2. Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
3. Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.