Gastroenterology & hepatologySep 9, 2026

Use of Glucagon-Like Peptide-1 Receptor Agonists Before and After Liver Transplant

GLP-1 Therapies Weekly Brief ↗PubMed ↗DOI ↗

Updated Sep 10, 2026

Abstract

Glucagon-like peptide-1 receptor agonists (GLP-1RAs) may safely improve glycemic control and support weight management in patients with advanced liver disease and liver transplant recipients.

Metabolic dysfunction, including obesity and type 2 diabetes, significantly impacts patients with advanced liver disease and liver transplant candidates.
GLP-1RAs are effective treatments for obesity and type 2 diabetes, offering benefits like sustained weight loss and improved insulin sensitivity.
Adoption of GLP-1RAs in patients with cirrhosis and liver transplant recipients has been limited due to concerns about gastrointestinal side effects and interactions with immunosuppressive drugs.
Emerging observational studies indicate potential safety and efficacy of GLP-1RAs for glycemic control and weight management in this population.
There is a need for prospective trials specifically focused on the use of GLP-1RAs in liver transplant contexts to better understand their effects.

Simplified

Metabolic dysfunction, manifesting as obesity, type 2 diabetes mellitus (T2DM), and related cardiometabolic comorbidities, has emerged as a major driver of morbidity among patients with advanced liver disease and liver transplant (LT) recipients. These conditions influence disease progression, transplant candidacy, perioperative risk, and long-term graft and patient outcomes. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have become cornerstone treatments for obesity and T2DM, with benefits extending beyond glycemic control to include sustained weight loss, improved insulin sensitivity, and reduction in cardiovascular risk. These pleiotropic metabolic effects are highly relevant across the LT continuum, where metabolic disease frequently complicates management both before and after transplant. Historically, adoption of GLP-1RA-based therapies in patients with cirrhosis and in LT recipients has been limited by concerns regarding gastrointestinal tolerability, nutritional status, frailty, and potential interactions with immunosuppressive medications. Emerging observational studies suggest that GLP-1RAs may safely improve glycemic control and support weight management before and after LT, although prospective transplant-specific trials remain needed. This article summarizes the mechanistic rationale, current clinical evidence, and practical considerations for GLP-1RA use in patients with advanced liver disease and LT recipients and highlights key knowledge gaps as well as future research priorities in transplant hepatology.

Use of Glucagon-Like Peptide-1 Receptor Agonists Before and After Liver Transplant

Abstract

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