Objective. The research tests the hypothesis that the Cytosorb hemofilter reduces the need for transfusions of blood derivatives during and after heart transplantation. The objectives include comparing transfusion needs and the duration of extracorporeal circulation between groups with and without Cytosorb, as well as analyzing ISHLT scores and signs of rejection. Subjects and methods. A retrospective cohort study was conducted on 81 heart transplant patients at the Clinical Hospital Dubrava, divided into two groups: one with Cytosorb (40) and one without (41). Results. In the study, the use of the Cytosorb hemofilter significantly reduced the need for erythrocyte concentrate transfusions in the post-operative period, which can have a positive impact on heart transplant outcomes. However, an increased use of cryoprecipitate was noted in the Cytosorb group, which might be one of the reasons for the reduced need for erythrocyte transfusions. Although an extended cardiac ischemia time was observed in the group treated with Cytosorb, there were no clinically significant consequences, even with poorer initial ISHLT scores, indicating a possible protective effect of Cytosorb in the early post - transplantation phases. Conclusion. Cytosorb reduces the need for certain transfusions, but with complex effects such as prolonged ischemia time. The results are promising but require further research to confirm efficacy and safety.