Transplant: Nutrition Guidelines after Solid Organ Transplant HF#494

 

Nutrition plays a vital role in the transplant process.  Before transplant, eating well and being at a healthy weight may help you heal from surgery faster.  After transplant, a good diet keeps playing a key role to keep you and your organ transplant healthy. 

 

Initial Nutrition Guidelines after Transplant

 

After surgery, you need to eat well to promote healing, fight and prevent infection, and gain back any weight you may have lost.  You may feel a decrease in hunger or a change in your sense of taste due to some of the medicines you will be taking.  Even though you may not feel hungry, it is vital to keep eating.  

 

Tips:

• Eat many small meals or 3 meals with 2-3 snacks in between.
• Include foods that are high in both calories and protein, such as yogurt, peanut butter, shakes, and lean meat sandwiches.
• Drink supplements such as Boost, Ensure, or Carnation Instant Breakfast drink.

 

Long Term Nutrition Guidelines after Transplant

 

After transplant, it’s key to start and maintain a healthy lifestyle to prevent problems that can occur such as diabetes, osteoporosis, and increased triglyceride and cholesterol levels.  Weight gain can also occur after transplant as a result of a number of factors, which include increased hunger due to steroids, poor food choices, lack of exercise, and family history of obesity.  Making healthy food choices can help you to prevent these problems.

 

1) To achieve or maintain a healthy weight:

• Eat regular, steady meals: 3 meals per day or small frequent meals.
• Control portion sizes at meals.
• When dining out, control portion sizes by splitting a meal with someone or choosing the kid-sized portion.
• Choose healthy snacks.
• Limit intake of high calorie, high fat sweets such as cakes, cookies, ice cream, and candy.
• Be active and make it a part of your daily routine at least 4-5 days a week.

 

2) Sodium: A diet low in sodium can help with blood pressure control and help to prevent fluid retention that can occur with the immunosuppressive medicines prednisone and cyclosporine.

 

To lower sodium intake:

• Avoid adding salt to your foods.  Try using herbs, spices, or herbal blends such as Mrs. Dash instead of salt.
• Avoid foods that contain large amounts of sodium.  These include processed foods such as ham, bacon, sausage, cheese, canned vegetables and soups, boxed meals.
• Avoid salt substitutes that contain potassium.
• Read food labels so you know which foods are high in salt.

 

3) Fat and cholesterol: The risk for heart disease is higher in transplant patients.  Cyclosporine and prednisone can raise cholesterol levels.  Being overweight or obese may also increase your risk for heart disease.

 

Guidelines for a heart healthy diet include:

• Choose lean meats. Choose fish and skinless poultry more often than red meat. Consume 6-8 ounces (cooked) per day.  Trim the fat off the meat, and remove the skin from poultry before cooking.
• Decrease the use of butter and lard. Choose margarine that is trans-fat free.
• Use olive oil, canola oil, or other vegetable oil with cooking.
• Avoid high fat, processed meats such as brats and sausage.
• Choose low fat dairy products such as skim or 1% milk, low fat yogurt, and frozen yogurt.  Limit intake of high fat dairy products such as whole milk, ice cream, and custards.
• Choose low fat versions of salad dressings, mayonnaise, sour cream, and cream cheese.
• Choose baked or low fat versions of crackers and chips.
• Increase your intake of high fiber foods such as whole-grain breads and cereals, whole-grain pastas, brown rice, dry beans & peas, fruits and vegetables.

 

4) Carbohydrates:   If you have diabetes or your blood sugar levels increase due to some of your medicines after transplant, you may need to consume a diet that has a consistent amount of carbohydrate at each meal. 

 

Guidelines for a consistent carbohydrate diet include:

• Eat meals at the same times each day.  Do not skip meals.
• Choose from a wide choice of foods at each meal that includes fruits, vegetables, proteins, and carbohydrates.
• Eat about the same amount of carbohydrate at each meal.  Carbohydrate foods include: breads, cereals, pasta, rice, starchy vegetables such as potatoes, corn, and peas, fruits, milk and yogurt, and sweets.
• Limit your intake of sweets such as sweetened sodas, candy, or jams.

 

5) Food Safety:

After transplant, you are more at risk of getting infections.  This includes those from bacteria and other germs that can cause foodborne illness.  To prevent foodborne illness, it is vital to practice good food safety.  In your transplant binder, you should have received a booklet titled “Food Safety for Transplant Recipients” from the U.S. Department of Agriculture Food Safety and Inspection Service.  This booklet provides detailed guidelines you can follow to lower your risk of foodborne illness.

 

Avoid High Risk Foods:

Meat	Fish/Seafood	Dairy/Eggs	Fruits/Vegetables
Raw/ undercooked meat or poultry	Raw/ undercooked fish	Unpasteurized Milk	Unwashed fruits & vegetables
Processed meat, such as hot dogs, deli meat, luncheon meat that has not been reheated*	Refrigerated smoked fish*	Cheese made from unpasteurized milk	Raw sprouts(alfalfa, bean, or other sprout)
Unpasteurized, refrigerated pates or meat spreads	Precooked seafood*	Foods containing raw or undercooked eggs

Adapted from:  “Food Safety for Transplant Recipients”  U.S. Department of Agriculture Food Safety and Inspection Service. 

 

*Processed meat, such as hot dogs, deli meat, and luncheon meat, precooked seafood, and refrigerated smoked fish must be reheated to 165 degrees before eating them.

 

      Food Safety Guidelines for Dining Out

• Choose restaurants that appear clean.
• Avoid items that contain uncooked or undercooked ingredients such as eggs, poultry, meat, or fish.  Don’t be shy to ask your server questions about the menu items.
• Avoid buffets.  It is hard to control portion sizes, and the buffet may contain foods that are undercooked or have sat at room temperature for too long. 
• Make sure to refrigerate leftovers as soon as possible, or within 2 hours.  If the air temperature is above 90 degrees F, refrigerate food within 1 hour.

6) Food Drug Interactions and Immunosuppressive Medicines:

Some medicines have interactions with certain foods that can get in the way of how the medicines work, or have side effects that can be controlled or prevented through changes in your diet.  Below are diet guidelines for your immunosuppressive medicines:

Corticosteroids (prednisone):

• Follow a low sodium diet to prevent fluid retention.
• Prevent weight gain caused by increased appetite:  control portion sizes, eat regular meals and make healthy food choices, and choose low calorie snacks.
• Make sure you are getting enough calcium and vitamin D.
• Include at least 2-3 servings of high protein foods per day.
• If you have high blood sugars, try to consume the same amount of carbohydrate at all meals.

Cyclosporine:

• Avoid grapefruit and pomegranate products.
• Avoid potassium supplements or salt substitutes that contain potassium while taking this drug.

Tacrolimus:

• Take this medicine either 1 hour before or 2 hours after meals.
• Avoid grapefruit and pomegranate products.
• Avoid potassium supplements or salt substitutes that contain potassium while taking this drug.
• Do not take with calcium, magnesium, antacids, supplements, or food.

Sirolimus:

• Avoid grapefruit or pomegranate products with this drug.
• Do not take with food unless you take it at the same time with the same type of food daily.
• Do not take with calcium, magnesium, antacids, or supplements.

Mycophenolate:

• Can be taken with or without food.  Taking it with food may help prevent stomach upset.
• Do not take with calcium, magnesium, antacids, or supplements.
• Take at least 1 hour before or 2 hours after calcium, magnesium, antacids, or supplements.

Dietary Supplements:

• Avoid herbal, dietary, or over-the-counter supplements unless approved by the transplant team first. 

 

If you have more questions please contact UW Health at one of the phone numbers listed below.

 

The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.

Last Updated: 08/14/2012

Copyright © 03/24/2010 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#494

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