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

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

Find It @ Sladen

Share

COinS