Kidney and liver transplant recipients now have better survival, amongst other, thanks to an efficient immunosuppressive treatment armamentarium, but certain post-transplant comorbidities should not be underestimated, such as hypertension, hypercholesterolemia and post-transplant diabetes mellitus (PTDM), which have an important impact on patient survival. GLP-1 analogues continue to prove their worth in patients with type 2 diabetes, providing good glycemic control while also helping to lose weight through a variety of mechanisms. However, this treatment has not been well studied in transplant patients. In this context, we were interested to describe the clinical and biochemical evolution of kidney and liver patients taking GLP-1 analogues and the safety of this treatment in this specific population.
This project is a descriptive, retrospective and monocentric study in which we collected various clinical and biological data for each patient who received a kidney or liver transplantation between January 2015 and December 2020 at the Lausanne University Hospital (CHUV). Data at four different time points were collected: at baseline, when the GLP-1 analogue was introduced, one year after GLP-1 analogue treatment initiation and at their last visit at the CHUV in 2023. We collected and analysed various demographic, clinical and biological parameters as well as the clinical course of the patients.
In our population of 390 patients, 296 patients received a kidney and 94 a liver transplant (KT and LT, respectively). In the 296 KT recipients, 16 (5.4%) were taking GLP-1 analogues and in the 94 LT recipients only eight (8.5%) patients were taking this treatment. In total, 24 solid-organ transplant patients were taking GLP-1 analogues in our cohort. Clinical parameters such as body mass index and blood pressure improved, renal function improved, liver function remained stable after one year of treatment, and Hb1Ac increased slightly after one year of treatment but improved at the last visit. Most of our results were not statistically significant. These results are applicable to both kidney and liver transplant recipients. No clinically relevant infections or rejections were reported either at the introduction or at one year, or at any other timepoint during the follow-up period.
In conclusion, GLP-1 analogues appear to be safe, but our study does not have the statistical power to confirm the efficacy in the control of diabetes and cardiovascular risk factors in the kidney and liver transplant population, although the clinical and biological parameters have improved or remained stable.