The goal of safe,transfusion free pump case for a 4 years old child of Jehovah's Witness (14 kg) was acheived by employing various techniques by the surgical team. The techniques included preopeartive buildup of hematocrit with r-erythropoetin and iron supplements. The anesthetic techniques included hypotensive anaesthesia in the prebypass period,use of tranxeminic acid,intraopeartive collection and transfusion of autologous blood, appropraite reversal of heparin and minimizing blood sampling. The techniques employed by the perfusionist included reduction of priming volume by shortening the bypass circuit,maintaining lower perfusion pressures and continous ultrafiltration.
The lowest hematocrit during surgey was 25% and the surgery and recovery was uneventful.

Key Words : Jehovah's Witness, Cardiopulmonary bypass, blood transfusion