Inclusion Criteria:  Patients undergoing cardiothoracic, cardiac, or aortic surgery Patients with complex surgical procedures and expected cardiopulmonary bypass (CPB) time over 120 minutes Patients capable of providing informed consent to participate in the study  Exclusion Criteria:  Patients not capable of providing informed consent to participate or who will not provide informed consent Patients with known congenital coagulopathies or hemostatic disorders (von Willebrands Disease, hemophilia etc) Patients with known erythrocyte- or platelet/HLA antibodies Patients with a particular increased surgical risk with expected need of ECMO Patients with preoperative EuroScore II ≥ 30  5. RhD negative patient