“…Both sirolimus and MMF profoundly inhibit B-cell proliferation and immunoglobulin production in a dose-dependent manner, compared with calcineurin inhibitors; both drugs induce significant B-cell apoptosis. [240][241][242][243] Although no longer commonly used, cyclophosphamide suppresses B-cell activation, proliferation, and differentiation and has been reportedly effective in AMR. 8,75,80,[244][245][246][247] Likewise, methotrexate has been reported as successful in treating refractory rejection but is not commonly used currently.…”