Can GLP-1RAs redefine transplantation standard of care?

Metabolic derangements, particularly obesity and post-transplant diabetes mellitus, remain major challenges in solid organ transplantation, contributing to graft dysfunction and increased morbidity. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have emerged as promising agents due to their glucose-lowering, weight-reducing, and cardiorenal protective effects. Accumulating evidence supports their efficacy in improving glycemic control, reducing body weight, and potentially enhancing graft and patient survival across diverse transplant populations. Notably, GLP-1RAs exhibit a favorable safety profile, with minimal risk of drug interactions or rejection. Early data also suggest immunomodulatory and anti-inflammatory benefits. Moreover, newer dual and triple incretin agonists offer enhanced metabolic efficacy, potentially extending these benefits further. While long-term outcomes remain under investigation, GLP-1RAs represent a compelling therapeutic option that may reshape metabolic management paradigms in both pre- and post-transplant care.