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RaparoBell is a branded oral formulation of the immunosuppressant sirolimus used in combination with calcineurin inhibitors in kidney transplant recipients, particularly ABO‑incompatible de novo living donor renal transplants, to prevent acute rejection by inhibiting mammalian target of rapamycin (mTOR) signaling in T cells and other immune effector cells.[21][3][7] As an mTOR inhibitor, sirolimus blocks IL‑2–driven cell cycle progression and clonal expansion of lymphocytes, thereby attenuating alloimmune responses against the graft while allowing CNI-based regimens to be optimized for efficacy and safety in post‑transplant maintenance therapy.[7][3]
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