The efficacy of TA in reducing bleeding has been proved beyond doubt in specialities like cardiac surgery, where it is used for prophylaxis in patients undergoing surgery on cardiopulmonary bypass. It is also very widely used in elective orthopaedic surgery like redo hip/knee replacement and for post-partum haemorrhage. It is also used on an outpatient basis in gynaecological patients with intermenstrual bleeding, DUB. Unfortunately, the experience in trauma patients is limited. With the widespread ban of Aprotinin, doctors are very cautious about using TA. This paper might give that sigh of breath for those doctors who want to use TA. I don't know the implications for the western word. But, for the third world, this has significant impact. With higher chance of transmitting communicable diseases by blood transfusion, doctors are looking at more and more alternatives for transfusion. Of course, one needs to be aware of dose reduction with impaired renal function.

Competing interests: None declared