GLP-1 Drugs May Increase Rejection Risk in Lung Transplant Recipients, Study Suggests

A recent study presented at the 2025 International Society for Heart and Lung Transplantation (ISHLT) annual meeting suggests that glucagon-like peptide-1 receptor agonists (GLP-1 RAs)—a class of drugs widely used to treat type 2 diabetes and obesity-may elevate the risk of organ rejection in lung transplant recipients.

Researchers, led by Dr. Zainab Dhanani and colleagues, investigated the outcomes of lung transplant patients who had been prescribed GLP-1 RAs such as semaglutide or liraglutide. The analysis compared these patients to matched controls who were not taking GLP-1 agents.
Findings indicated a statistically significant increase in episodes of acute rejection and possibly chronic lung allograft dysfunction (CLAD) in those receiving GLP-1 RAs. GLP-1 RAs have been celebrated for their cardiometabolic benefits and their role in weight reduction, especially in transplant populations where obesity is a risk factor. However, their influence on immune modulation may unintentionally provoke immune responses against transplanted lungs. The underlying mechanism remains unclear but may involve increased immune activation or altered pharmacokinetics of immunosuppressants.
The researchers caution against immediate changes in clinical practice, emphasizing the need for further large-scale studies to validate these findings. However, they recommend careful monitoring of lung transplant patients who are prescribed GLP-1 agents and a multidisciplinary approach when considering their use in this population. As GLP-1 RAs gain popularity for metabolic disease management, this study highlights the importance of evaluating potential immunological consequences in vulnerable populations, such as transplant recipients.

Reference:

International Society for Heart and Lung Transplantation. Source Reference: Dhanani Z, et al “The impact of glucagon-like peptide-1 receptor agonists on lung transplant outcomes” ISHLT 2025.

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