Routine versus on-demand ECMO during lung transplant
Official title: RoutinE Versus On-demand Intraoperative Extracorporeal Membrane Oxygenation (ECMO) During LUng TransplantatION (REVOLUTION)
Run by Centre hospitalier de l'Université de Montréal (CHUM) · NCT06615492 · Data updated 2026-11-12
This trial tests whether using ECMO routinely during lung transplant or only when needed leads to fewer complications for people having a lung transplant.
Quick facts
| Study type | Interventional |
|---|---|
| Ages | 18 Years and up |
| Sex | All |
| Enrollment | 218 (estimated) |
| Sponsor | Centre hospitalier de l'Université de Montréal (CHUM) Academic / other |
| Locations | 4 sites (Edmonton, Alberta and 3 other locations) |
| Status | Recruiting |
| Started | November 5, 2024 |
| Main results expected | November 5, 2028 |
| Study ends | January 15, 2029 |
| Registry record updated | December 23, 2025 |
| Trial ID | NCT06615492 on ClinicalTrials.gov |
Is this trial a fit for you?
✓Likely a good fit
Adults scheduled for single or bilateral lung transplantation who can give consent and do not meet exclusions like retransplantation, multi-organ transplant, severe pulmonary hypertension, significant ventricular dysfunction, or contraindication to heparin are ideal candidates.
✕Probably not a fit
Patients who require mandatory cardiopulmonary support (for example severe pulmonary hypertension, moderate-to-severe RV dysfunction, or LVEF <45%), those undergoing retransplantation or multi-organ transplant, or those with contraindications to heparin anticoagulation are unlikely to benefit from randomization in this trial.
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, randomized controlled trial comparing two intraoperative cardiopulmonary support strategies: routine use of extracorporeal membrane oxygenation (ECMO) for all lung transplants versus selective (on-demand) ECMO initiated only for hypoxia or hemodynamic instability. Eligible adults scheduled for lung transplantation are randomized to one of the two arms, with predefined exclusion criteria such as retransplantation, multi-organ transplant, severe pulmonary hypertension, significant ventricular dysfunction, or contraindication to heparin. The study will measure intraoperative stability and postoperative hypoperfusion-related complications using standardized perioperative protocols across participating centers. The trial is conducted at multiple Canadian lung transplant centers following uniform ECMO and follow-up procedures.
Why it matters
Potential benefit: If successful, routine intraoperative ECMO could reduce intraoperative instability and lower rates of postoperative complications related to organ hypoperfusion such as kidney injury and stroke.
How similar studies have gone: ECMO is widely used and observational series suggest benefits for intraoperative support, but randomized comparisons of routine versus on-demand intraoperative ECMO are limited.
Who can join: the full rules
Show full inclusion / exclusion criteria
Inclusion Criteria: * Patients undergoing lung transplant surgery Exclusion Criteria: * Inability to provide consent for the study * Retransplantation * Multi-organ transplantation * Contra-indication to standard heparin anticoagulation (e.g., heparin-induced thrombocytopenia) * Lung transplant recipients where intraoperative cardiopulmonary support is mandatory: * Severe pulmonary hypertension (PH): 1. Systolic pulmonary artery pressure (PAP) ≥ 80 mm Hg on the most recent echocardiography, right heart catheterization, or pulmonary artery catheter measurement 2. Mean PAP ≥ 55 mm Hg on the most recent echocardiography, right heart catheterization, or pulmonary artery catheter measurement 3. The ratio of mean pulmonary to systemic artery pressure of \> 0.66 * Moderate to severe right ventricular (RV) hypokinesis or dysfunction * Left ventricular dysfunction: Defined as ejection fraction (LVEF) less than 45% on echocardiography, ventriculography, computed tomography (CT), or magnetic resonance imaging (MRI) * Patients requiring concomitant cardiac surgery: For example, significant coronary artery disease (CAD) requiring surgical grafting
Where it's running
-
Centre Hospitalier de l'Universite de Montreal
Montreal, Quebec, Canada Recruiting -
Univeristy of Alberta & Alberta Health Services
Edmonton, Alberta, Canada Not yet recruiting -
Vancouver General Hospital
Vancouver, British Columbia, Canada Not yet recruiting -
University Health Network / Toronto General Hospiatl
Toronto, Ontario, Canada Not yet recruiting
Study contacts
- Study coordinator: Basil Nasir, MD
- Email: basilsnasir@gmail.com
- Phone: 514-890-8000
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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.