Ischemia-reperfusion and leukocyte adhesion plays an important role in delayed graft function (DGF). A monoclonal antibody (moAb) against the adhesion molecule LFA-1 (odulimomab) in comparison to a polyclonal Ab ATG(F) was tested in a primate model of kidney transplantation using human blood and ex-vivo hemoperfusion, wether the rate of DGF could be reduced. Cynomolgus monkeys (n=14) were unilaterally nephrectomized, the right kidney pedicle was clamped for 45 min. (warm ischemia), kidneys were flushed with Eurocollins solution and stored at 4°C for 24 hours. Concordant reperfusion followed with 500 ml heparinized ABO-compatible human blood following cross-check in n=4 kidneys without (control group I), n=5 kidneys with odulimomab in concentration of 2 mg/l (group II) and ATG with 20 mg/l (group III, n=5). Measurement of resistance as well as blood and urine samples were collected to determine electrolyte balance, albumine loss, alpha and pi-GST, LDH and TNF-alpha. After 3 hrs. reperfusion, specimens underwent routine histology (H.E.) and transmission electron microscopy. Control group showed higher resistance (median 12,5 vs. 8,15 and 7,95 mmHG/min x ml at 5 min.) compared to II and III with increasing difference. Urine alpha-GST was 8,85 times higher in group I at 60 min (vs. II and III). Superior structural integrity of tubular epithelial cells and less leukocyte adhesion was visible in II and III. Effective kidney protection after warm and cold ischemia can be reached with antiadhesive therapy via monoclonal as well as polyclonal Ab´s. Further studies will clarify the mechanism.