MON-702 Semaglutide as a Potential Tool in Pre-Lung Transplant Weight Loss Optimization

Abstract Disclosure: R. Ali: None. K. Fain: None. H. Keyt: None. C. Solis-Herrera: None. M.A. Escobar Vasco: None. Background/Objective: Patients with end-stage lung disease go through an extensive screening process prior to transplant. Obesity and uncontrolled type 2 diabetes mellitus are known unfavorable risk factors that lead to poor outcomes. Case Report: We present the case of a 69-year-old male with Stage IV Chronic Obstructive Pulmonary Disease (COPD) on chronic oxygen, Type 2 Diabetes Mellitus (T2DM) on insulin, and Class II Obesity who presented for pre-lung transplant optimization. The patient had a body mass index (BMI) of 38.05 kg/m2, surpassing the institutional transplant eligibility criteria of BMI < 32 kg/m2. He was started on titrated Semaglutide for weight loss. After six months of therapy, including eight weeks of pulmonary rehabilitation, the patient’s BMI decreased to 30.5 kg/m2, losing 25kg (55lbs) in weight. His 6-Minute Walk Test (6MWT) distance improved from 135m to 256m. Additionally, the patient’s Forced Vital Capacity (FVC) improved from 44% to 70% and he was successfully weaned off oxygen at rest. Discussion: Although the patient now qualified for transplant, the pre-lung transplant committee determined it was too early given significant improvements in respiratory status. Currently, there are no randomized trials demonstrating the effects of Semaglutide in pre-lung transplant patients. While weight-loss programs exist, chronic hypoxia and corticosteroids make weight management an ongoing challenge for patients with end-stage lung disease. After 16 months of Semaglutide, the patient lost a total of 35kg (77lbs), no longer required oxygen on exertion, and reported significant improvement in symptom burden. His insulin requirements also decreased from 72 units to 36 units of glargine. The patient continues to be followed by pre-lung transplant evaluation committee in the outpatient setting. Conclusion: This case highlights the emerging potential of Semaglutide in pre-lung transplant optimization and its effects on improved respiratory function in patients with advanced lung disease. Presentation: Monday, July 14, 2025