Antegrade Autologous Blood Reinfusion After CPB

The Effect of Antegrade Pump Blood Reinfusion Via Crystalloid "Chase" Technique on Postoperative Transfusion Requirements in Adult Cardiac Surgery Patients: A Prospective Observational Study

This prospective observational study aims to evaluate the effect of antegrade pump blood reinfusion using the crystalloid "chase" technique on postoperative transfusion requirements in adult patients undergoing cardiac surgery with cardiopulmonary bypass. At the end of cardiopulmonary bypass, blood remaining within the cardiopulmonary bypass circuit is reinfused antegradely through the arterial line using a crystalloid chase, without collection or storage. Blood remaining within the bypass circuit after surgery represents a valuable source of autologous blood, and its reinfusion may contribute to perioperative blood conservation strategies. Patients receiving antegrade pump blood reinfusion via the chase technique will be compared with those managed without reinfusion, without any intervention by the investigators. The primary outcome is postoperative blood transfusion requirement.

Study Overview

• Status: Recruiting
• Conditions: Coronary Artery Disease
• Intervention / Treatment: Procedure: Antegrade Pump Blood Reinfusion; Other: No Anterograde Pump Blood Reinfusion

• Study Type: Observational
• Enrollment (Estimated): 130

Contacts and Locations

• Study Contact: Name: Yılmaz; Phone Number: +902622252700; Email: kocaelish@saglik.gov.tr

Study Locations

• Turkey (Türkiye)
  • Izmit
    • Kocaeli, Izmit, Turkey (Türkiye)
      • Recruiting
      • Kocaeli City Hospital
      • Contact: Mehmet Yılmaz; Phone Number: +902622552700; Email: kocaelish@saglik.gov.tr

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

The study population includes adult patients (18-80 years) scheduled for elective, primary isolated coronary artery bypass grafting (CABG) using cardiopulmonary bypass at Kocaeli City Hospital.

Description

Inclusion Criteria:

• Age 18 to 80 years
• Patients undergoing elective, isolated coronary artery bypass grafting surgery using cardiopulmonary bypass (on-pump).

Exclusion Criteria:

• Emergency or Redo cardiac surgery
• Concomitant cardiac procedures (e.g., valve repair/replacement or aortic surgery).
• Planned or intraoperative conversion to off-pump coronary artery bypass grafting
• Preoperative hematocrit <30% or known inherited/acquired bleeding disorders.
• Preoperative left ventricular ejection fraction <30%.
• Thrombocytopenia (e.g., platelet count <100×10³/µL) or abnormal coagulation tests.
• Use of antiplatelet agents other than aspirin without appropriate discontinuation according to current guideline-recommended preoperative intervals.
• Use of anticoagulant therapy without appropriate preoperative discontinuation according to current guideline recommendations.
• Use of non-steroidal anti-inflammatory drugs (NSAIDs) without appropriate discontinuation prior to surgery.
• Severe renal dysfunction (eGFR <30 mL/min/1.73 m² or dialysis) and/or severe hepatic dysfunction (Child-Pugh B-C or coagulopathy).
• Active infection or systemic inflammatory/autoimmune disease.
• Active malignancy requiring ongoing treatment
• Refusal or inability to provide written informed consent.

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Antegrade Pump Blood Reinfusion (Chase Technique); Adult patients undergoing cardiac surgery with cardiopulmonary bypass in whom antegrade pump blood reinfusion is performed at the end of bypass using the crystalloid chase technique, as part of routine clinical practice.	Procedure: Antegrade Pump Blood Reinfusion; Adult patients undergoing cardiac surgery with cardiopulmonary bypass in whom antegrade pump blood reinfusion is performed at the end of bypass using the crystalloid chase technique, as part of routine clinical practice.
No Pump Blood Reinfusion; Adult patients undergoing cardiac surgery with cardiopulmonary bypass in whom antegrade pump blood reinfusion is not performed at the end of bypass, and standard clinical management is applied.	Other: No Anterograde Pump Blood Reinfusion; Adult patients undergoing cardiac surgery with cardiopulmonary bypass in whom anterograde pump blood reinfusion is not performed at the end of bypass. Standard institutional clinical management is applied.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Postoperative Blood Transfusion Requirement	Incidence of allogeneic blood transfusion within the first 24 hours after surgery.	From the end of surgery to 24 hours postoperatively

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Postoperative Drainage Volume	Total postoperative chest drainage volume within the first 24 hours after surgery.	From the end of surgery to 24 hours postoperatively
Number of Transfused Blood Units	Total number of allogeneic blood transfusion units administered within the first 24 hours after surgery.	From the end of surgery to 24 hours postoperatively

Collaborators and Investigators

• Sponsor: Kocaeli City Hospital
• Investigators: Principal Investigator: Zeynep Yasemin Tavsanoglu, MD, Kocaeli City Hospital, Department of Anesthesiology and Reanimation

Study record dates

Study Major Dates

• Study Start (Actual): February 23, 2026
• Primary Completion (Estimated): June 1, 2026
• Study Completion (Estimated): June 15, 2026

Study Registration Dates

• First Submitted: February 12, 2026
• First Submitted That Met QC Criteria: February 12, 2026
• First Posted (Actual): February 19, 2026

Study Record Updates

• Last Update Posted (Actual): February 24, 2026
• Last Update Submitted That Met QC Criteria: February 23, 2026
• Last Verified: February 1, 2026

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Vascular Diseases; Cardiovascular Diseases; Heart Diseases; Arteriosclerosis; Arterial Occlusive Diseases; Coronary Disease; Myocardial Ischemia; Coronary Artery Disease
• Other Study ID Numbers: KSH_ZYT_1

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No