Eligibility Criteria:
Inclusion Criteria:
* Adult patients with no upper age limit,
* Scheduled cardiac surgery with cardiopulmonary bypass,
* Patients with preoperative thrombocytopenia strictly \<150,000/mm3
* Surgery performed with a blood recovery system using centrifugation (Cell Saver type) or equivalent,
* Feasibility of a first injection (Romiplostim or Placebo) between D-14 and D-10 before surgery,
* Surgery requiring the administration of antiplatelet and/or anticoagulant therapy for a minimum of 1 month postoperatively.
Exclusion Criteria:
* Inability to administer the first injection of Romiplostim or Placebo within 10 days prior to surgery,
* Cardiac surgery without cardiopulmonary bypass,
* Coronary artery bypass grafting due to one or more significant coronary stenoses,
* Tangential filtration blood recovery system (i-SEP SAMEĀ® type) planned for intraoperative use or absence of intraoperative blood recovery system due to investigator choice or availability issues,
* Planned use of aprotinin as an antifibrinolytic agent during surgery,
* Patient with contraindication to discontinuation of all antiplatelet therapy before surgery (with discontinuation at least 3 days before surgery for acetylsalicylic acid and at least 5 days before surgery for clopidogrel/ticagrelor),
* Hereditary or acquired thrombophilia with or without a history of thrombosis,
* History of ischemic or hemorrhagic stroke,
* History of phlebitis, pulmonary embolism, or portal vein thrombosis,
* History of heart attack with stent placement less than one year ago,
* Current limb immobilization (e.g., plaster cast for ankle fracture) or inability to walk independently due to limited mobility (e.g., paralysis),
* Current immobilization of a limb (e.g., plaster cast for ankle fracture) or inability to walk independently due to motor limitation (e.g., complete paralysis of a limb) or medical contraindication (e.g., strict bed rest required),
* Myelogram indicating malignant hematological disease or blast cells strictly greater than 5%,
* Malignant diseases with last follow-up indicating disease progression,
* Severe chronic liver disease with a CHILD-PUGH score \> 6 (measured without decompensation),
* Treatment with thrombopoietin receptor agonist received within 3 months prior to inclusion,
* Treatment with JAK2 inhibitor currently underway or within the last month,
* Treatment with Rituximab within the last 7.5 months or intravenous immunoglobulin within the last 40 days,
* Ongoing treatment with corticosteroids at doses equal to or greater than 20mg of hydrocortisone, 5mg of prednisone/or prednisolone, 4mg of methylprednisone, or 0.75mg of dexamethasone,
* Known hemophilia,
* Hypersensitivity to romiplostim or any of its excipients, or to proteins derived from E. coli,
* Context of hyperchloremia, hypernatremia, or major water and salt retention with anasarca refractory to medical treatment,
* Pregnant women or women of childbearing age who are not using effective contraception,
* Currently using combined oral contraceptive pills or oral hormone replacement therapy containing estrogen,
* Breastfeeding women,
* Minors,
* Adults under guardianship, curatorship, or judicial protection,
* Patients who do not speak French,
* Patients without Social Security coverage.