{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T17:08:54Z","timestamp":1775063334388,"version":"3.50.1"},"reference-count":24,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"vor","delay-in-days":90,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100003243","name":"Ministerstvo Zdravotnictv\u00ed Cesk\u00e9 Republiky","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003243","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Transplantation"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Urinary tract infections (UTIs) are common complications following simultaneous pancreas and kidney transplantation (SPK). The role of specific immunosuppressive agents in modulating UTI incidence and recurrence remains poorly understood.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this retrospective, single\u2010center study, we analyzed 164 SPK recipients randomized to receive either sirolimus or mycophenolate mofetil (MMF) in combination with tacrolimus. The incidence of UTIs, relapses, recurrences, and UTI\u2010related hospitalizations was assessed over a 10\u2010year follow\u2010up. Univariable and multivariable negative binomial regression models were used to evaluate associations with immunosuppressive regimens and clinical outcomes in both intention\u2010to\u2010treat (ITT) and per\u2010protocol analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 572 UTI episodes were recorded during follow\u2010up (0.102 per 100 recipient\u2010transplant days). No significant differences in overall UTI incidence or UTI\u2010related hospitalizations were observed between the sirolimus and MMF groups. However, in the multivariable per\u2010protocol analysis, the sirolimus group experienced significantly fewer UTI\u2010related hospitalizations (IRR 0.46; 95% CI, 0.23\u20130.94;\n                      <jats:italic>p<\/jats:italic>\n                      = 0.034) and relapses (IRR 0.54; 95% CI, 0.30\u20130.97;\n                      <jats:italic>p<\/jats:italic>\n                      = 0.039). Significant risk factors for UTIs included female sex, JJ stent placement, and pretransplant urological abnormalities. Recurrent UTIs were associated with lower 10\u2010year kidney graft survival (52% vs. 75%;\n                      <jats:italic>p<\/jats:italic>\n                      = 0.01) but had no impact on pancreas graft or patient survival.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>While overall UTI incidence did not differ between immunosuppressive regimens, sirolimus use was associated with fewer hospitalizations and relapses. These findings indicate a potential clinical benefit of sirolimus in selected high\u2010risk SPK recipients, highlighting the need for further prospective investigation.<\/jats:p>\n                    <jats:p>\n                      <jats:bold>Trial Registration:<\/jats:bold>\n                      ClinicalTrials.gov identifier: NCT00140543\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/joot\/6985179","type":"journal-article","created":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T15:23:23Z","timestamp":1775057003000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Sirolimus Versus Mycophenolate Mofetil in Simultaneous Pancreas\u2013Kidney Transplantation: Impact on Urinary Tract Infection Rates"],"prefix":"10.1155","volume":"2026","author":[{"given":"Barbora","family":"P\u00ed\u0161ov\u00e1","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3956-5968","authenticated-orcid":false,"given":"\u0160\u00e1rka","family":"Chytilov\u00e1","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0448-4351","authenticated-orcid":false,"given":"Franti\u0161ek","family":"Saudek","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0944-8189","authenticated-orcid":false,"given":"Peter","family":"Girman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,4,1]]},"reference":[{"key":"e_1_2_11_1_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.transproceed.2004.03.114"},{"key":"e_1_2_11_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.transproceed.2009.06.065"},{"key":"e_1_2_11_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0000000000002960"},{"key":"e_1_2_11_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2016.04.222"},{"key":"e_1_2_11_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40620-019-00585-3"},{"key":"e_1_2_11_6_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2362.2008.02014.x"},{"key":"e_1_2_11_7_2","doi-asserted-by":"publisher","DOI":"10.3389\/ti.2024.12235"},{"key":"e_1_2_11_8_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-3062.2012.00744.x"},{"key":"e_1_2_11_9_2","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics11081456"},{"key":"e_1_2_11_10_2","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD003961.pub2"},{"key":"e_1_2_11_11_2","doi-asserted-by":"publisher","DOI":"10.1517\/14656566.2.11.1903"},{"key":"e_1_2_11_12_2","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.15622"},{"key":"e_1_2_11_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11033-023-08283-x"},{"key":"e_1_2_11_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2018.02.009"},{"key":"e_1_2_11_15_2","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.13221216"},{"key":"e_1_2_11_16_2","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2018010009"},{"key":"e_1_2_11_17_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2011.03674.x"},{"key":"e_1_2_11_18_2","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.13507"},{"key":"e_1_2_11_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.transproceed.2022.03.031"},{"key":"e_1_2_11_20_2","doi-asserted-by":"publisher","DOI":"10.1111\/tid.12828"},{"key":"e_1_2_11_21_2","doi-asserted-by":"publisher","DOI":"10.1111\/1469-0691.12165"},{"key":"e_1_2_11_22_2","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0b013e3182a04997"},{"key":"e_1_2_11_23_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-0012.2005.00327.x"},{"key":"e_1_2_11_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2015.07.019"}],"container-title":["Journal 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