The possibilities of reducing the number of transfusions of heterologous blood are haemodilution, intraoperative auto-transfusion using the Bentley pump, and the administration of autologous deep-frozen erythrocytes. Indications, contraindications as well as the pros and cons of the various methods are discussed. Today, the use of coagulation factors is mainly limited to the treatment of congenital coagulation disorders, and prothrombin concentrate to application in bleeding problems arising from coumarin application. For other indications these preparations have been replaced by the therapeutically more effective fresh frozen plasma. The problems of transfusion hepatitis are briefly mentioned. Only small amounts of whole blood are usually required for transfusion in neonates and infants. Freshly collected whole blood has the best therapeutic effect. The indications and risks of the transfusion of freshly drawn blood are examined. The collection of fresh blood from a donor pool comprised of physicians and nursing staff from our own clinic has proved effective. The selection and control of these blood donors is discussed.