Transfusion in lung transplantation is common, and despite improved techniques and limitations in the use of mechanical circulatory support (MCS), the incidence of massive transfusion has remained stable over the years. The consequences of blood transfusion (blood cells, plasma, platelet concentrates) are deleterious for patients and increase primary graft dysfunction and mortality risk.

Whole blood viscoelastic testing devices have shown its effectiveness in monitoring coagulation and fibrinolytic function during cardiac surgery, liver transplantation or trauma. So far, few delocalized biology tools have been evaluated in lung transplantation.

The main objective of this study is to determine if the use of a transfusion algorithm based on whole blood viscoelastic test with Quantra® test reduce transfusion during lung transplantation.

Inclusion Criteria:

• Patients undergoing double-lung transplantation
• Patient is ≥ 18 years-old
• Patient is willing to participate, and is willing to consent
• Patient affiliated to a national health insurance

Exclusion Criteria:

• Patient is younger than 18 years-old
• Patient with an indication for non double-lung transplantation
• Patient under extracorporeal membrane oxygenation in bridge to transplantation
• Patient with surgery under cardiopulmonary bypass
• Patient benefiting from a multi-organ transplantation
• Patient being deprived of liberty or under guardianship
• Patient refusing to participate