A 61-year-old man with severe factor XI deficiency presented forcoronary artery bypass surgery. The clotting deficiency was correctedpreoperatively with factor XI concentrate. Surgery resulted in severepostoperative haemorrhage of 55 liters of blood. This was managedsuccessfully with a cell saver device (Haemonetics). Repeated platelettransfusions were ineffective in correcting the platelet dysfunction. Thesevere haemorrhage stopped suddenly after the infusion of 4 units of freshblood. The case demonstrates how fresh blood can be useful in themanagement of severe haemorrhage after massive blood transfusion.