The use of fresh blood to control severe haemorrhage associated with massive blood transfusion after cardiopulmonary bypass.

A 61-year-old man with severe factor XI deficiency presented for coronary artery bypass surgery. The clotting deficiency was corrected preoperatively with factor XI concentrate. Surgery resulted in severe postoperative haemorrhage of 55 liters of blood. This was managed successfully with a cell saver device (Haemonetics). Repeated platelet transfusions were ineffective in correcting the platelet dysfunction. The severe haemorrhage stopped suddenly after the infusion of 4 units of fresh blood. The case demonstrates how fresh blood can be useful in the management of severe haemorrhage after massive blood transfusion.