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Anti-CD25 mAb + sirolimus + mycophenolate mofetil is a combination immunosuppressive regimen investigated as a calcineurin inhibitor (CNI)-free protocol for liver transplant recipients with renal impairment. The regimen consists of three primary components: **basiliximab** (an anti-CD25 monoclonal antibody), **sirolimus** (an mTOR inhibitor), and **mycophenolate mofetil** (an antimetabolite). Basiliximab is used for induction therapy to block the interleukin-2 (IL-2) receptor on activated T cells. Sirolimus is typically introduced in a delayed fashion to inhibit the mechanistic target of rapamycin (mTOR) pathway, which is critical for T-cell cell cycle progression. Mycophenolate mofetil (MMF) acts by inhibiting inosine monophosphate dehydrogenase (IMPDH), the rate-limiting enzyme in the de novo synthesis of guanosine nucleotides, which lymphocytes rely on for proliferation. This combination is specifically designed to provide effective prophylaxis against organ rejection while sparing renal function by eliminating the need for nephrotoxic CNIs like tacrolimus or cyclosporine.
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