Glucagon-Like Peptide-2 Therapy Outcomes Following Intestinal and Multivisceral Transplantation: A Multicenter Experience

Document Type

Conference Proceeding

Publication Date

8-1-2025

Publication Title

Am J Transplant

Abstract

Purpose: Glucagon-like peptide-2 (GLP-2) plays a critical role in intestinal adaptation, mucosal growth, and nutrient absorption. While GLP-2 therapy has shown benefits in patients with short bowel syndrome, its effects following intestinal transplantation (IT) and multivisceral transplantation (MVT) remain unknown. This study aims to describe the clinical outcomes of patients who received GLP-2 therapy after IT or MVT, providing insights into its potential role in post-transplant recovery and long-term outcomes. Methods: A retrospective analysis was conducted on sev7en patients who received GLP-2 therapy following IT or MVT across four transplant centers between 2014 and 2024. Results: Among the 7 transplant recipients, there were 2 men and 5 women. 5 patients underwent IT alone, while 2 underwent MVT. The median age at transplantation was 46 years (mean 45, range 19-62), with a median transplant waitlist time of 71±109 days. 71% of recipients developed short bowel syndrome due to bowel resection, while 29% had dysmotility as the underlying cause. All patients received teduglutide, with 57% starting treatment prior to undergoing IT. At GLP-2 initiation, 71% of patients were dependent on total parenteral nutrition (TPN), and with treatment, 67% successfully transitioned off TPN. GLP-2 therapy was eventually discontinued in 71% of patients, with bowel obstruction being the most common reason (67%). Notably, all patients retained their colons post-transplant. No patients had a history of colon polyps or colon cancer, and no polyps were detected during follow-up colonoscopies. Only one patient died 66 days post-transplant due to septic shock from a leg abscess, which occurred 10 days after discontinuing GLP-2 treatment. The remaining patients surpassed the 1- and 3-year survival milestones and did not have any infectious complications on treatment. Conclusions: GLP-2 therapy may play a beneficial role in intestinal adaptation and post-transplant recovery, potentially facilitating independence from TPN in IT and MVT recipients. Bowel obstruction appears to be the main complication leading to therapy discontinuation and occurred in the majority of patients undergoing GLP-2 therapy. Despite these challenges, survival outcomes were generally favorable, warranting further investigation into the long-term benefits and risks of GLP-2 therapy in transplant recipients. CITATION INFORMATION: Toiv A., Justus H., Lee V., Altamura-Murgia G., Horslen S., Weiner J., Schiano T., Segovia M., Jafri S. Glucagon-Like Peptide-2 Therapy Outcomes Following Intestinal and Multivisceral Transplantation: A Multicenter Experience AJT, Volume 25, Issue 8 Supplement 1 DISCLOSURES: A. Toiv: None.

Volume

25

Issue

8

First Page

S844

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