Glucagon-like peptide-1 agonists usage to widen the living donor pool for liver transplantation: A novel metabolic strategy

Glucagon-like peptide-1 (GLP-1)/glucose-dependent insulinotropic polypeptide receptor agonists' use as a weight loss tool is gradually expanding. They can be used as bridging therapies to reduce weight in potential living donors for liver transplantation and improve graft quality. A living donor with high body mass index is likely to be declined in most living donor programs due to concerns about donor safety and graft function. Reducing weight before surgical procedures can improve outcomes and lower the incidence of morbidity and mortality. Growing clinical evidence supports the advantage of GLP-1 receptor agonists as well as GLP-1/glucose-dependent insulinotropic polypeptide receptor agonists as bridging therapies to minimize perioperative complications. However, these agents should be used with caution due to concerns about side effects, particularly delayed gastric emptying and the risk of aspiration. This article summarizes the available evidence about the promising use of new weight-reducing agents to expand graft pool by including higher body mass index donors after weight optimization.