Abstract: TH-PO1268
GLP-1 Receptor Agonist Therapy Within Three Years After Kidney Transplant Is Associated with Improved Graft and Patient Survival
Session Information
- Late-Breaking Research Posters
October 22, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 2002 Transplantation: Clinical
Authors
- Salam, Sakib, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
- Cashion, Winn T., Medical College of Wisconsin, Milwaukee, Wisconsin, United States
- Yu, Duo, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
- Raigani, Siavash, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
Background
Kidney transplant (KTx) recipients with diabetes and/or obesity are at increased risk of graft loss and death. Use of glucagon-like peptide-1 receptor agonists (GLP-1RA) in KTx recipients remains understudied but could substantially improve post-transplant outcomes in this cohort.
Methods
Adults who received KTx between 2019-2024 in the TriNetX US network were included. The exposure was GLP-1RA (including dual GLP-1/GIP) treatment within 3 years post-KTx; controls were recipients who were never treated with GLP-1RA. Using a landmark design, time zero was defined as date of GLP-1RA initiation for the exposed and 1-year post-KTx for controls. The primary outcome of interest was incidence of major adverse cardiovascular events (MACE); secondary outcomes were overall survival and graft failure. Propensity scores were calculated for inverse probability treatment weighting (IPTW) to balance baseline characteristics between groups.
Results
19,273 KTx recipients were identified during the study period, of which 2,604 (13.5%) received GLP-1RA therapy within 3 years of KTx. Median time to initiate GLP-1RA was 358 days (versus 365 days in controls). After IPTW, all measured covariates appeared well-balanced. Patients in the GLP-1RA cohort had a significantly reduced risk of 3-point MACE (myocardial infarct, stroke, or death) compared to controls (hazard ratio (HR) 0.84 [95% CI 0.71-1.00], p=0.047). When death was considered a competing risk, the incidence of non-fatal MACE was similar between groups (HR 1.03 [0.81-1.31], p = 0.8). However, overall survival was significantly improved in the GLP-1RA group (HR 0.61 [0.50-0.75], p < 0.001). Similarly, death-censored graft failure (HR 0.76 [0.61-0.94], p = 0.010) was significantly improved in the GLP-1RA group (Fig. 1).
Conclusion
KTx recipients who received GLP-1RA therapy within 3 years of transplant were found to have improved graft and overall survival compared to propensity score balanced controls. A clinical study to evaluate the efficacy of GLP-1RA therapy in KTx recipients with increased cardiometabolic risk is warranted.
Figure 1