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This combination immunosuppressive regimen was developed and evaluated by the University of Wisconsin, Madison, for use in renal transplantation. It consists of induction therapy with alemtuzumab (Campath-1H) and rituximab, followed by maintenance therapy with mycophenolate mofetil (CellCept). The regimen is specifically designed to allow for a calcineurin inhibitor (CNI)-free protocol, aiming to avoid the long-term nephrotoxicity and metabolic side effects (such as hypertension and diabetes) associated with standard CNI-based therapies like tacrolimus or cyclosporine. Alemtuzumab provides potent lymphocyte depletion by targeting CD52, while rituximab targets CD20-positive B cells. Mycophenolate mofetil serves as the primary maintenance agent by inhibiting inosine monophosphate dehydrogenase, thereby suppressing lymphocyte proliferation.
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