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Nutrition After Transplant

Guidelines for a Smooth Recovery

The Wellness Ambassadors know first-hand how exciting it can be to no longer have to follow a dialysis diet. You will still, however, need to be careful when making decisions about the foods you eat.

Nutrition will play an important role in your life after transplant. Your relationship with food will need to be safe and positive; one to help you protect your new kidney and maintain a healthy lifestyle. While a successful transplant will allow fewer dietary restrictions in your life, there still are guidelines you will need to follow. These guidelines will allow for a smooth recovery and long-term wellness.

Handling Food Safely

Food Safety

The way you handle your food post-transplant is important as it will help protect your new kidney from infection. When preparing foods, be sure to exercise food safety by washing your hands, checking for “use-by” dates, using thermometers, and avoiding foods that have been sitting out.

Handling Food Safely

Healthy Eating

The way you handle your food post-transplant is important as it will help protect your new kidney from infection. When preparing foods, be sure to exercise food safety by washing your hands, checking for “use-by” dates, using thermometers, and avoiding foods that have been sitting out.

Adjusting How You Eat

Generally after transplant, you may need to follow a diet low in salt and high in fiber. A balanced diet includes a variety of fresh fruits and vegetables, lean meats, reduced-fat dairy products, whole grains, and plenty of water. Drink at least 3 liters (101 ounces or 3.2 quarts) of water to keep your new kidney well hydrated.

Additionally, you may need to avoid eating certain types of foods. Your healthcare team can help you understand which foods you should avoid – and why. The dietitian at your transplant center can help you find a diet that is right for you.

Healthy Eating

Adjusting How You Eat

Generally after transplant, you may need to follow a diet low in salt and high in fiber. A balanced diet includes a variety of fresh fruits and vegetables, lean meats, reduced-fat dairy products, whole grains, and plenty of water. Drink at least 3 liters (101 ounces or 3.2 quarts) of water to keep your new kidney well hydrated.

Additionally, you may need to avoid eating certain types of foods. Your healthcare team can help you understand which foods you should avoid – and why. The dietitian at your transplant center can help you find a diet that is right for you.

Healthy Eating

Adjusting How You Eat

Generally after transplant, you may need to follow a diet low in salt and high in fiber. A balanced diet includes a variety of fresh fruits and vegetables, lean meats, reduced-fat dairy products, whole grains, and plenty of water. Drink at least 3 liters (101 ounces or 3.2 quarts) of water to keep your new kidney well hydrated.

Additionally, you may need to avoid eating certain types of foods. Your healthcare team can help you understand which foods you should avoid – and why. The dietitian at your transplant center can help you find a diet that is right for you.

Healthy Eating

Adjusting How You Eat

Healthy Eating

Generally after transplant, you may need to follow a diet low in salt and high in fiber. A balanced diet includes a variety of fresh fruits and vegetables, lean meats, reduced-fat dairy products, whole grains, and plenty of water. Drink at least 3 liters (101 ounces or 3.2 quarts) of water to keep your new kidney well hydrated.

Additionally, you may need to avoid eating certain types of foods. Your healthcare team can help you understand which foods you should avoid – and why. The dietitian at your transplant center can help you find a diet that is right for you.

Avoiding High-Risk Foods


Raw or Undercooked Food

You can help lower your chances of infection from food by avoiding certain ‘high-risk’ foods because they are more likely to have bacteria that can cause an infection.

In the order pictured below, left to right, raw or undercooked: (top) meat, poultry, fish (sushi, sashimi), prawns, shrimp, (bottom) crab, squid, octopus, clams and oysters, and ceviche.

Raw Beef Tartare
Undercooked Chicken
Sushi
Raw Prawns
Raw Shrimp
Raw Crab
Raw Squid
Raw Octopus
Raw Clams and Oysters
Ceviche

Avoid undercooked food specialties such as rare steak, seared tuna, and unpasteurized, refrigerated pâtés or meat spreads. Deli meats and luncheon meats should be heated until they are steaming hot before consuming, to destroy harmful bacteria. See FDA's "Food Safety for Transplant Patients" for more information.

Avoid undercooked food specialties such as rare steak, seared tuna, and unpasteurized, refrigerated pâtés or meat spreads. Deli meats and luncheon meats should be heated until they are steaming hot before consuming, to destroy harmful bacteria. See FDA's "Food Safety for Transplant Patients" (linked on the website) for more information.

Rare Steak
Seared Tuna
Liver Pâtés
Deli Meats


Dairy Products

Be sure to avoid unpasteurized milk, and cheese products such as Feta, Blue cheese, Queso fresco, Brie, and Camembert.

Pictured below, left to right, is an unpasteurized cheese label, a Washington State mandatory warning about raw milk products, and an undercooked (poached) egg.

Unpasteurized Cheese

Fruits and Vegetables

Do not eat or drink grapefruit or grapefruit juice, pomegranate or pomegranate juice, or eat starfruit or pummelo fruit, especially if you are taking cyclosporine or Prograf (specific immunosuppressive medicines). Do not eat unwashed raw fruits or damaged fruits, unwashed raw vegetables and unwashed salads, unpasteurized juices or ciders, food from salad bars or buffets, alfalfa or bean sprouts. Some of these are pictured below.

Grapefruit
Pomegranate
Star Fruit
Unwashed Plums
Unwashed Potatoes
Unpasteurized Apple Cider
Salad Bar
Alfalfa Sprouts
Bean Sprouts

Be sure that these foods are not added to, or an ingredient of, anything you eat or drink. If you have questions or need more information about a healthy eating plan after your kidney transplant, ask your transplant team to refer you to a registered renal dietitian.

Weight Gain and Increased Appetite

Weight gain is a common concern after receiving a transplant, as it affects about two-thirds of all kidney transplant recipients. The pre-transplant diet can be very restrictive so patients sometimes gain weight once they are able to eat a wider variety of foods.

You may also regain or experience a better appetite after transplant, leading you to consume more food (and calories) than before. In some cases, you may have experienced malnutrition and weight loss pre-transplant, so the weight gain may be positive. However, be sure not to “tip the scale” beyond what your care team considers a healthy weight for you.

Although immunosuppressant medications are essential to help avoid rejection of your new kidney, they can also contribute to weight gain (and potentially other health complications). However, under no circumstances should you stop taking your medications to avoid weight gain.

See below for examples of potential health complications.


Hypertension

High Blood Pressure


Heart Disease

Clogging of the coronary arteries


High Cholesterol

Narrowing of the arteries


Gout (Inflammatory Arthritis)

Uric acid crystals form in the joints


Diabetes

Too much sugar in your diet


Liver Disease

Two stages are reversible, the last is not


Sleep Apnea

Normal breathing is interrupted during sleep


Osteoarthritis

Cartilage that cushions the ends of the bones wears down over time


Hypertension

High blood pressure

Heart Disease

Clogging of the coronary arteries

High Cholesterol

Narrowing of the arteries

Gout (Inflammatory Arthritis)

Uric acid crystals form in the joints

Gout (Inflammatory Arthritis)

Uric acid crytals form in the joints

Gout (Inflammatory Arthritis)

Uric acid crytals form in the joints

Diabetes

Too much sugar in your diet

Diabetes

Too much sugar in your diet

Liver Disease

Two stages are reversible, the last is not

Liver Disease

Two stages are reversible, the last is not

Sleep Apnea

Normal breathing is interrupted during sleep

Sleep Apnea

Normal breathing is interrupted during sleep

Osteoarthritis

Cartilage that cushions the ends of the bones wears down over time

Frequently Asked Questions

Transplant Nutrition
  1. Can I eat what I want now? While you may have a new increase in appetite due to your transplant, you still have to make conscious decisions about the food you eat as certain foods may affect you differently. It is likely you will be able to enjoy the foods you love, but it will need to be in moderation. Be sure to reach out to your transplant team.

  2. Will my medications interact with the food I eat? Depending on the medications prescribed to you, there is a chance the foods you eat can interact with your medications and cause short to long term effects. It is important to follow the instructions for your medications, taking them when you should. As always, refer to your transplant team for specific guidelines.

  3. Will I gain or lose weight after my transplant? Losing or gaining weight is possible after transplant and depends on various factors including medications, changes to appetite, or personal issues including depression or stress. If you experience any of these issues, please reach out to your transplant team.

  4. Do I still need to watch my fluid intake? One of the keys to success post-transplant is staying well hydrated. It is recommended you drink plenty of water; typically, 3 liters or 3.2 quarts per day.

  5. Will I be able to eat at buffets, salad bars, and food trucks? Due to the potential for food contamination, you should not eat at buffets and salad bars, as food is usually “self-serve”, allowing multiple diners to handle the food. With regard to food trucks and food carts, it is hard to confirm their cleanliness or safety, e.g., how food is prepared, how long precooked food is held before serving, etc.

  6. Am I able to drink alcohol now that I have had a transplant? You may be able to consume alcohol post-transplant, but it could possibly interact with your medications. Speak to your doctor and dietitian before you drink any alcohol.

  7. Am I able to follow current diet trends such as the Keto diet? A Keto diet is not a well-balanced diet. It may result in increased levels of cholesterol and uric acid (gout). Do not go on any diet trends without checking with your nephrologist.

  8. Now that I have a transplant, may I take nutritional supplements and multi-vitamins? Your ability to take supplements and vitamins will depend on a variety of factors. Consult your doctor and dietician before taking any.

  9. Can I still enjoy dishes from my culture? Cultural foods could be a part of your diet depending on various factors. Your dietitian will help you adjust your diet to your cultural preferences.

Unpasteurized Cheese

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