Decreased Rate of Rejections Post Liver Transplant in Patients on a Glucagon-Like Peptide 1 (GLP-1) Analogue

Document Type

Conference Proceeding

Publication Date

8-1-2025

Publication Title

Am J Transplant

Keywords

glucagon like peptide 1, semaglutide, tirzepatide, adult, body mass, cerebrovascular accident, cohort analysis, comorbidity, complication, conference abstract, controlled study, diabetes mellitus, drug combination, drug therapy, end stage renal disease, female, graft rejection, human, hypertension, incidence, liver disease, liver graft rejection, liver transplantation, major clinical study, male, mortality, multicenter study, retrospective study, steatohepatitis, surgery

Abstract

Purpose: Rejection is prevalent in patients undergoing liver transplant (LT), with studies showing a relation of Body Mass Index (BMI) to post transplant outcomes, including rates of rejection. Recently, Glucagon-like peptide-1(GLP-1) analogues are increasingly being used in post-transplant patients. We aimed to assess the association of semaglutide and tirzepatide with transplant rejection in patients with BMI > 30. Methods: Patients who underwent LTs at our institution were included from 1 2018-12 2023. Inclusion criteria was BMI > 30. We did a retrospective cohort study to assess whether they received GLP-1 analogues, including semaglutide and tirzepatide, after the liver transplant. Data including patient demographics and comorbidities was collected. The primary outcome was transplant rejection at 1 and 2-3 years. The secondary outcome was 3-year mortality. Results: 137 patients were included who underwent liver transplant from 01 2018-12 2023 with a BMI > 30. Of these, 33(24.1%) were exposed to semaglutide or tirzepatide while 104 (75.9%) had no such exposure after transplant. The mean age of the population was 58.86 + - 8.2 in the case group and 62.08 + - 9.2 in the control group. 23 (69.7%) were male in the case group while 69 (66.3%) were male in the control group. Comorbidities, including HTN, stroke and ESRD were comparable in both groups. 27 (87.9%) in the case group had diabetes while 37(35.6%) in the control group had diabetes (p=0.001). Mean BMI for the case group was 36.34 ± 4.81 and mean BMI for the control group was 33.9 ± 3.82 (p=0.01). Underlying liver disease prior to transplant was similar between the 2 groups, with Metabolic Dysfunction-Associated Steatohepatitis (MASH) being the most prevalent. For outcomes, 2(6.1%) patients in the exposed group had rejection within 3 years, compared to 24(23.1%) in the control group (p=0.03). Of these, both the patients in the control group had rejection within 1 year compared to 20(19.4%) patients in the control group who had rejection within 1 year. At 3 years, there were 0 deaths in the case group compared to 4 (3.9%) deaths in the control group (P=1.0). Conclusions: In our cohort, the use of semaglutide and tirzepatide was associated with a decreased incidence of liver transplant rejections in patients with BMI > 30. We were limited by single center and smaller number of patients. Further large scale, multicenter studies are needed to confirm the efficacy of these medications, possibly suggesting a more significant role post liver transplant. [Formula presented] CITATION INFORMATION: Faisal M., Garg N., Aburumman R., Saleem A., Shahzil M., Fatima M., Faisal M., Jafri S. Decreased Rate of Rejections Post Liver Transplant in Patients on a Glucagon-Like Peptide 1 (GLP-1) Analogue AJT, Volume 25, Issue 8 Supplement 1 DISCLOSURES: M. Faisal: None.

Volume

25

Issue

8

First Page

S487

Last Page

S488

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