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Sleeve gastrectomy most effectively enhances transplant eligibility and survival in morbidly obese ESRD patients, with dual GLP-1/GIP agonists as a viable alternative. 

The study published in the June 2025 issue of American Journal of Surgery Researchers examined the impact of weight management on transplant access and survival among individuals with obesity and ESRD.   

They applied a Markov state transition model to assess the effectiveness of 3 weight loss strategies in individuals with morbid obesity and ESRD. The interventions included a GLP-1 receptor agonist, GIP receptor agonist, and sleeve gastrectomy (SG). Eligibility for kidney transplantation requires achieving a BMI below 35 kg/m².   

The results showed that 14.74% of individuals who underwent SG received a kidney transplant, compared to 9.06% of those treated with GLP-1/GIP RA and 4.83% with GLP-1 RA. The SG led to faster weight reduction, with 27.49% achieving a BMI below 35 kg/m² within 6 months and SG also showed a survival benefit, especially in those with higher pre-intervention BMIs.   

Investigators concluded that SG led to the highest transplant rates, while dual GLP-1/GIP RA therapy also showed meaningful effectiveness and remained a promising pharmacologic option. 

Source: americanjournalofsurgery.com/article/S0002-9610(25)00298-3/abstract