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Mycophenolate mofetil + sirolimus is a combination of two immunosuppressive agents used primarily in organ transplantation to prevent rejection. Mycophenolate mofetil is a prodrug that inhibits inosine monophosphate dehydrogenase (IMPDH), leading to suppression of T and B lymphocyte proliferation by blocking de novo purine synthesis. Sirolimus, also known as rapamycin, is an mTOR (mammalian target of rapamycin) inhibitor that blocks cytokine-driven cell proliferation by inhibiting the mTOR pathway after binding FKBP12. The combination offers a calcineurin inhibitor-free regimen with complementary mechanisms, aiming to reduce nephrotoxicity and chronic allograft nephropathy while maintaining effective immunosuppression[1][2][8]. This regimen has been studied in kidney, heart, and pancreas transplantation settings.
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