Heparin-free Extracorporeal Membrane Oxygenation Support During Clinical Lung Transplantation
Status:
Recruiting
Trial end date:
2024-06-30
Target enrollment:
Participant gender:
Summary
The aim of this investigation is to compare two different anti-coagulation strategies in
clinical lung transplantation where lung implantations are all routinely done on
veno-arterial (VA) extracorporeal membrane oxygenation (ECMO) support at the investigators'
institution. No heparinization (Zero-Hep) will be compared to standard low-dose
heparinization (Standard). Traditionally, the Vienna group has used a standard low-dose
heparin protocol with unfractionated heparin (UFH) administered as a bolus upon ECMO
cannulation. With heparin-coated tubing and intraoperative ECMO flow never falling below 1
L/min, the likelihood of thromboembolic events is believed to be negligible. To date, the
investigators have not experienced any thromboembolic events during intra-operative ECMO use.
On the other hand, the use of UFH entails an increased risk for bleeding, so it follows that
avoidance of additional heparin may be beneficial. Generally, risks and benefits of
heparinization during these short procedures have not yet been thoroughly analyzed. This
study will investigate the feasibility of running heparin free VA-ECMO support during
clinical lung transplantation and its effect on clinical outcomes and inflammatory response
comparing 40 patients receiving a standard dose of heparin versus 40 patients receiving
placebo in a randomized, double-blind study design.