Sodium glucose cotransporter 2 inhibitor use after heart transplant: Current knowledge and potential applications

Raven, Lisa M. and Brinker, Lina and Sideris, Konstantinos and Muir, Christopher A. and Carter, Spencer and Beddhu, Srinivasan and Macdonald, Peter S. and Stehlik, Josef (2025) Sodium glucose cotransporter 2 inhibitor use after heart transplant: Current knowledge and potential applications. American Journal of Transplantation, 25 (11). pp.2303-2312. ISSN 16006135

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Link to published document: https://doi.org/10.1016/j.ajt.2025.08.013

Abstract

Heart transplant (HTx) markedly improves survival and quality of life in patients with stage D heart failure. However, long-term survival post-HTx is limited by increased risk and progression of cardiovascular disease, chronic kidney disease, and metabolic disease. There is a lack of proven mitigating treatments for these morbidities, and transplant recipients are frequently excluded from clinical trials of novel agents, which could be of benefit in this population. Sodium glucose cotransporter 2 inhibitors (SGLT2i), initially a treatment for type 2 diabetes, are now established treatments for heart failure or chronic kidney disease, with or without type 2 diabetes. There are strong mechanistic reasons that suggest HTx recipients should derive specific benefits from SGLT2i. However, prospective data to confirm these hypotheses in transplant recipient populations are limited. In this review, we present mechanisms through which SGLT2i may benefit HTx recipients, including renoprotective, glycemic, vascular, anti-inflammatory, and erythropoietic effects. We present a summary of experimental studies of SGLT2i in reversal of calcineurin inhibitor-associated kidney and pancreatic injury, and retrospective studies of SGLT2i in HTx recipients demonstrating improvement in glycaemia, weight, and renal function. Prospective trials of SGLT2i in HTx recipients are required, and the currently registered trials are highlighted.

Item Type: Article
Subjects: R Medicine > R Medicine (General)
Depositing User: Repository Administrator
Date Deposited: 21 Dec 2025 23:32
Last Modified: 21 Dec 2025 23:32
URI: http://eprints.victorchang.edu.au/id/eprint/1792

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