COLUMBUS, Ohio — For patients with end-stage kidney disease, excess weight can stand between them and a life-saving transplant. Now, researchers at The Ohio State University Wexner Medical Center have found a promising solution that’s helping obese patients shed the pounds needed to qualify for kidney transplantation.

A new study from Ohio State’s Comprehensive Transplant Center demonstrates that obese patients with end-stage kidney disease and diabetes can safely use GLP-1 weight loss medications to reach transplant eligibility requirements.

The challenge facing these patients is significant. Obesity increases risks of infection, delayed kidney function, kidney loss and death during transplant surgery. Patients with a BMI greater than 40 often struggle to be listed for transplant due to these elevated risks.

“When patients are deferred because of their weight, many never get transplanted because they’re not able to lose weight through traditional weight loss methods and there could be a long wait time for bariatric surgery,” said Dr. Priya Singh, a transplant nephrologist at Ohio State Wexner Medical Center and clinical associate professor of internal medicine at The Ohio State University College of Medicine.

Launched in March 2024, the kidney transplant weight loss program combines diet, exercise, counseling and GLP-1 injection medications to help patients achieve their weight loss goals. The program targets patients with a BMI of 38 or greater who need to lose less than 40 pounds. Patients with type 1 diabetes, gastrointestinal issues, a history of pancreatic cancer and multiple endocrine neoplasia-2 are excluded from the program.

Researchers followed six kidney transplant candidates over 12 months. Five patients were receiving dialysis treatment, while one had stage 5 chronic kidney disease. The group had a median BMI of 39.5 and a median weight of 277.5 pounds, with a median weight loss requirement of 27.5 pounds.

The patients received either semaglutide or tirzepatide based on their insurance coverage, along with dietary counseling and exercise guidance monitored by a dietitian.

The results were encouraging. All patients tolerated the medications without side effects, and no dose adjustments were required for kidney function concerns. Every participant achieved their weight loss goal, with a median weight dropping to 246 pounds and a median BMI falling to 35.6. The average time to reach the desired weight and BMI was 135 days.

Three of the six patients have successfully received kidney transplants, while the remaining three are active on the transplant waitlist.

Singh’s research builds on her ongoing study of GLP-1 medications in kidney transplant recipients with type 2 diabetes. Since 2018, she has been investigating how these medications can support healthy glucose levels and weight loss while reducing insulin dependence without interfering with immunosuppressive drugs.

Her retrospective chart review of adult kidney transplant recipients with type 2 diabetes showed sustained benefits over time. Recipients maintained significant reductions in weight, BMI and blood sugar levels, with weight reduction of 2.6 pounds at one year, 8 pounds at three years, and 9 pounds at five years compared to baseline.

The medication also showed cardiovascular benefits. Major adverse cardiac events decreased from 45.5 percent to 18.9 percent, and median insulin requirements dropped from 50 to 27 units over five years.

“Obesity is a lifestyle disease and it can be very difficult to sustain the weight loss,” Singh noted. “I always tell my patients in the clinic that it’s diet, exercise and only then can the medication work.”

Singh’s future research will examine the safe use of GLP-1 medications in other types of organ transplant recipients, potentially expanding treatment options for more patients awaiting life-saving procedures.