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Sirolimus Versus Mycophenolate Mofetil in Simultaneous Pancreas-Kidney Transplantation: Impact on Urinary Tract
Barbora Píšová1, Šárka Chytilová2, František Saudek1
1Department of Diabetes, Institute of Clinical and Experimental Medicine, Prague, Czech Republic, ikem.cz.
Journal of Transplantation
|April 3, 2026
Summary
Sirolimus may reduce hospitalizations and relapses for urinary tract infections (UTIs) after simultaneous pancreas and kidney transplantation (SPK). Further research is needed to confirm sirolimus benefits in high-risk SPK patients.
Area of Science:
- Nephrology
- Transplantation Immunology
- Infectious Diseases
Background:
- Urinary tract infections (UTIs) are frequent complications in simultaneous pancreas and kidney transplantation (SPK) recipients.
- The impact of specific immunosuppressive drugs on UTI development and recurrence is not well understood.
Purpose of the Study:
- To compare the incidence of UTIs and related outcomes in SPK recipients treated with sirolimus versus mycophenolate mofetil (MMF).
Main Methods:
- A retrospective analysis of 164 SPK recipients randomized to sirolimus or MMF plus tacrolimus.
- Assessed UTI incidence, relapses, recurrences, and hospitalizations over 10 years.
- Utilized negative binomial regression for statistical analysis.
Main Results:
- No significant difference in overall UTI incidence between sirolimus and MMF groups.
- Sirolimus group showed fewer UTI-related hospitalizations and relapses in per-protocol analysis.
- Female sex, JJ stent, and pretransplant urological issues were UTI risk factors.
Conclusions:
- Sirolimus use may offer a clinical advantage by reducing hospitalizations and relapses in SPK patients.
- Further prospective studies are warranted to validate these findings.
- Recurrent UTIs negatively impacted long-term kidney graft survival.
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