Successful Implementation of a Multidisciplinary Weight Loss Program Including GLP1 Receptor Agonists for Liver...

Area of Science:

• Hepatology
• Metabolic Medicine
• Transplant Surgery

Background:

• High body mass index (BMI) >40 is a relative contraindication for liver transplantation.
• Limited research exists on effective weight loss strategies for liver transplant candidates with obesity.
• Multidisciplinary support and pharmacotherapy are hypothesized to aid weight loss for transplant eligibility.

Purpose of the Study:

• To evaluate the efficacy of a multidisciplinary clinic in facilitating weight loss for liver transplant candidates with high BMI.
• To assess the role of glucagon-like protein 1 receptor agonists in achieving transplant eligibility criteria.

Main Methods:

• Patients (BMI >40 or >35 with abdominal adiposity) were enrolled in a specialized Liver Metabolic Clinic.
• Individualized support was provided by hepatologists, dieticians, and counselors.
• Antiobesity medications, including glucagon-like peptide 1 receptor agonists, were prescribed and patients monitored for weight loss.

Main Results:

• 19 patients with a median BMI of 42 underwent the program, aiming for a median weight loss of 14.1 kg.
• 84% had metabolic dysfunction-associated steatohepatitis; 7 had comorbid hepatocellular carcinoma.
• Median weight loss was 11.7 kg, with 8 patients receiving a transplant and 4 more waitlisted. 15 patients received GLP-1 receptor agonists.

Conclusions:

• Individualized dietary and medical support effectively facilitates weight loss in patients with high BMI.
• This approach can help patients achieve the necessary criteria for liver transplant eligibility.
• The study highlights the potential of integrated care models in managing obesity for transplant candidates.