The effect of retrograde autologous priming on transfusion requirements after cardiac surgery [TheRAPy]: a multiple period vanguard cluster crossover trial – Australian arm (Trial Not Registered)

Significant blood dilution occurs during cardiac surgery involving cardiopulmonary bypass. One way to minimise this is a technique called retrograde autologous priming (RAP) whereby the patient’s own blood is used to prime the bypass circuit instead of a clear fluid solution. This study aims to assess the feasibility of a full-scale trial to determine if the routine use of RAP decreases the amount of blood transfused up to 72 hours post-surgery.

Trial phase

Pilot

Trial participation type

This trial is for clinical research of something other than a drug or device.

Principal investigator

A/Prof Tim Coulson

Key inclusion data

INCLUSION: Undergoing elective or urgent cardiac surgery requiring cardiopulmonary bypass (CPB) between 1 January 2027 and 31 December 2027. EXCLUSION: Routine RAP Policy: Patients deemed unsuitable for retrograde autologous priming (RAP) by the treating surgeon, anaesthetist, or perfusionist based on clinical assessment, these may include: Haemodynamic instability prior to CPB initiation/ Emergency initiation of CPB. Cardiogenic shock or requirement for preoperative mechanical circulatory support, including extracorporeal membrane oxygenation (ECMO), Impella®, or intra-aortic balloon pump (IABP).