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August 1975

The Leukocyte Aggregation Test: Immunodiagnostic Applications and Immunotherapeutic Implications for Clinical Renal Transplantation

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).

Arch Surg. 1975;110(8):984-990. doi:10.1001/archsurg.1975.01360140128025

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.