Introduction: Antibodies are believed to be detrimental to graft survival. We present a cohort of living donor renal transplant (LDRTx) patients who were subjected to pre-transplant stem cell infusion (SCI) and are having stable graft function in spite of presence of antibodies.

Material and methods: Patients subjected to pre-transplant SCI having stable graft function were divided in 2 groups, group-1 with HLA class 1/ 2 antibodies (tested by luminex assay) and group-2 with no antibodies. Their demographics, serum creatinine (SCr), rejection episodes, immunosuppression requirement, peripheral T-regulatory cells (pTregs) [CD127^lowCD25^highCD4⁺] and protocol biopsy in subset of patients were evaluated.

Results: There were 138 patients, 90 (81 males, 9 females) of group-1 and 48 (46 males, 2 females) of group-2 with mean age 32.5 and 31.7 years and mean HLA-match, 2.42 and 3.02 respectively. Over a mean follow-up of 6 years in the former and 5.76 years in the later, mean SCr (mg/dL) was 1.42 and 1.4 respectively. There were 6.6% rejection episodes in former and 8.3% episodes in the later. Totally 47.8% patients in group-1 vs. 56.3% in group-2 were on low dose steroid monotherapy. Protocol biopsies were unremarkable in 58.3% patients of group-1 and 76.9% patients of group-2. Mean pTregs were 3.3% in group-1 and 3.5% in group-2.

Conclusion: To our knowledge this is the first clinical report showing stable renal allograft function inspite of presence of antibodies. We believe that SCI has protected the graft from immune injury in addition to induction of T^regs.

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