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The Leukocyte Aggregation TestImmunodiagnostic Applications and Immunotherapeutic Implications for Clinical Renal Transplantation
Barry D. Kahan, PhD, MD;
Frank Krumlovsky, MD;
Peter Ivanovitch, MD;
James Greenwald, MD;
Casmir Firlit, MD, PhD;
John Bergan, MD;
Baldwin H. Tom, PhD
Arch Surg. 1975;110(8):984-990.
Abstract
The leukocyte aggregation test (LAT) detects the in vitro adhesion of sensitized, but not nonimmune, recipient leukocytes onto donor kidney cell monolayers. The test specifically detects cell-mediated homograft immunity up to 15 days prior to the appearance of clinical signs or alteration of chemical indexes. The presence of a positive reaction always signified incipient homograft rejection, which was usually controlled by intravenously administered, high-dose methylprednisolone sodium succinate (Solu-Medrol) therapy. There was no instance in which methylprednisolone treatment effectively reversed rejection in the presence of a negative leukocyte aggregation test. One common form of homograft rejection may be characterized by positive LAT results, a cellular infiltrate on the renal biopsy specimen, and sensitivity to methylprednisolone therapy.
Author Affiliations
From the Laboratory of Surgical Immunology of the departments of surgery and physiology (Drs. Kahan and Tom), and the Division of Organ Transplantation of the departments of surgery and medicine (Drs. Kahan, Krumlovsky, Ivanovitch, Firlit, and Bergan), Northwestern University Medical Center and Veterans Administration Research Hospital, Chicago, and St. Margaret's Hospital, Hammond, Ind (Dr. Greenwald).
Footnotes
Accepted for publication March 14, 1975.
Read before the 32nd annual meeting of the Central Surgical Association, Chicago, Feb 28, 1975.
Reprint requests to 303 E Chicago Ave, Chicago, IL 60611 (Dr. Kahan).
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