Short-Term Semaglutide Improves Safety in High Body Weight Recipients Undergoing Living Donor Liver Transplant: A Case Report

Living donor liver transplant has recently become increasingly important as a solution to the shortage of deceased donor livers. The success of adult-to-adult living donor liver transplant depends on achievement of an appropriate graft-to-recipient weight ratio to prevent complications like small-for-size syndrome. This case report describes the use of oral semaglutide, a glucagon-like peptide-1 receptor agonist, to faci-litate pretransplant weight loss in an obese patient (body mass index 39.1, in kg/m²) undergoing living donor liver transplant. The patient experienced a significant weight loss of 10 kg during a period of 19 days with semaglutide treatment, which improved the graft-to-recipient weight ratio (from 0.66% to 0.786%) and resulted in an uneventful living donor liver transplant procedure with no postoperative issues. This case marks the first documented case of using semaglutide for pretransplant weight loss in liver transplant recipients, highlighting its potential to improve surgical outcomes for overweight patients awaiting transplant.