COOK, SPEILLER, SLAUSNER, SINHA, KIKKAWA AND VEITH 
215 
process to occur although the xenograft studies 
i reported herein show that foreign erythrocyte 
agglutination plays a major role in lung xeno- 
graft rejection per se. The apparent importance 
of this agglutination reaction in xenograft re- 
jection makes it imperative that a better under- 
standing of its origins and underlying mecha- 
nism be sought. 
SUMMARY 
Using this model we have made in vivo ob- 
servations which suggest that massive erythro- 
cyte aggregation and mechanical plugging of 
capillaries is the earliest event in hyperacute 
rejection. Early studies of renal xenograft re- 
jection suggest a similar process occurs. 
ACKNOWLEDGMENT 
We would like to acknowledge the technical 
assistance of Adele Giro, Michael Torres, and 
Israel Colon. 
REFERENCES 
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DISCUSSION 
Chairman Frank J. Veith: The paper is 
now open for discussion. 
Questioner: (Inaudible) 
Dr. Cook : We are in the process now of try- 
ing to attenuate the process. We have made the 
observations just over the last 6 months, and 
one of our first attempts is to pretreat the 
animals with steroids. I don't think it's pre- 
mature to say that pretreatment about 4 hours 
before either renal or pulmonary xenografts 
seems to slow down the rate of red cell aggrega- 
tion and prolongs the entire rejection process, 
including the edema phase and hemorrhaging. 
We hope to use this method of attenuation to 
retard the acute rejection process so that we 
will be able to describe it more clearly and 
thoroughly. 
Gerald Moss, Rennselaer Polytechnic In- 
stitute, Troy, N.Y. : Actually I want to ask 
something that relates to Dr. Veith's earlier 
comments regarding our exchange, here, of 
some specific techniques. In our lab we needed 
a denervated left lung in a dog with a normal 
right lung, and we developed a series of proce- 
dures so that denervation can now be accom- 
plished in under an hour by technicians, and, 
most importantly, with never more than ten 
minutes of ischemia. There are a couple of tricks 
involved, but the most important is to do the 
atrial cuff without interrupting blood flow. We 
do this with a wire loop inside the left atrium, 
which we secure in place with staples. And the 
only ischemia is during the transsection and re- 
anastomosis of the pulmonary artery, which we 
also have techniques to speed up. With only ten 
