Diet and Transplantation

If you have a new organ transplant, you are probably wondering if your diet will differ from the one you followed before your transplant. You can get help in planning your diet after transplant from your doctor and dietitian.

Yes. After an organ transplant, your diet still plays a big role. If you were on dialysis and had a kidney transplant, you may find that this diet is easier to follow than the one you were on during dialysis.

Yes. Your diet may be affected by medicines you need to prevent rejection of your new kidney transplant. Some common anti-rejection medicines that may affect your diet include:

• steroids (prednisone)
• cyclosporine (Sandimmune, Neoral, Gengraf)
• tacrolimus (Prograf)
• azathioprine (Imuran)
• mycophenolate (CellCept)
• Sirolimus (Rapamune)

This list will continue to grow as new medicines are developed. These medicines may change the way your body works in different ways. Some of these medicines can cause increases in appetite, blood fats (like cholesterol and triglycerides), blood sugar levels, potassium, and blood pressure. Some may also lower magnesium and other minerals. Your medical team will monitor these changes over time.

Many people have a better appetite after they get a transplant, and they gain unwanted weight. It is important to eat the right portion sizes for weight management as well as blood sugar control. Limit high-calorie foods such as fatty foods, sweets, pastries, and other foods high in fat or sugar. You can help control your calories by eating:

• Foods high in  fiber, such as vegetables and fruits
• Lean meat, skinned poultry and fish
• Nonfat dairy products, such as skim milk
• Sugar-free drinks like water, unsweetened tea, coffee or milk

Controlling your weight will lower your chance of having problems such as heart disease, diabetes, and high blood pressure. If you gain unwanted weight, you will need to exercise more and follow a lower calorie diet. Ask your doctor to refer you to a dietitian to plan lower calorie meals and snacks.

Fat (cholesterol or triglyceride) levels in your blood may be high. High levels of cholesterol and triglyceride can cause heart disease. There are many steps you can take to lower the fat and cholesterol in your blood, like exercising and eating fruits and vegetables.

You should know some important facts about foods high in carbohydrates:

• Carbohydrates come from sugars and starches.
• They provide fuel and energy for your body.
• When you take steroid medication, it is hard for your body to use extra carbohydrates. This can lead to high blood sugar levels and may cause diabetes.

Most people still need to limit salt after they get a transplant, although it is different with each person. Transplant medicines, especially steroids, may cause your body to hold on to fluid, and salt makes this problem worse. Increased fluid in the body raises blood pressure. Controlling blood pressure is very important to your transplant. Your doctor will decide how much sodium is best for you. It is a good idea to limit foods high in salt, such as:

• Table salt
• Cured meats, such as ham, bacon, and sausage
• Lunch meats, such as bologna, salami, and hot dogs
• Pre-packaged frozen dinners
• Ramen noodles, boxed noodles, and potato and rice mixes
• Canned soups and pasta sauce
• Pickled foods, such as olives, pickles, and sauerkraut
• Snack foods, such as salted chips, nuts, pretzels, and popcorn

Protein is important for the following reasons:

• It builds and repairs muscles and tissues
• It helps you heal after the transplant operation

• Meat, chicken and fish
• Milk, yogurt and cheese
• Eggs
• Peanut butter
• Beans and peas

• Oranges
• Bananas
• Tomatoes and tomato produces, such as pizza and spaghetti sauces.
• Potatoes
• Milk and yogurt

You may need to pay close attention to your calcium and phosphorus levels. If you have been ill for a while, your body may lack the balance of calcium and phosphorus needed for healthy bones, especially if you had kidney disease. In the months after your transplant, your doctor will check for possible bone loss and talk to you about the best way to keep your bones as healthy as possible.

In the meantime, if your kidney is working well, adults need about two servings a day from the dairy group (such as milk, cheese and yogurt). Unless your doctor or dietitian has told you not to use these foods, try to include them in your meals. Your doctor may decide you need more calcium, phosphorus, or vitamin D than your diet provides and may tell you to take a supplement. Some transplant medicines can make your phosphorus levels low, so eating 2 to 3 high-phosphorus foods each day, such as beans, nuts, and dairy, can help you stay at a healthy level.

Another way to make sure you are getting enough phosphorus and calcium is from vitamins or supplements, but you should not start any supplements on your own as this could cause problems with your transplant. Remember to review all herbs and supplements with your medical team.

After a transplant, your new diet may be higher in protein and lower in sugar due to the effects of steroids and other medicines. Work with your doctor and dietitian to keep your diet and blood sugar in good control.

If you would like more information, please contact us.

© 2022 National Kidney Foundation. All rights reserved. This material does not constitute medical advice. It is intended for informational purposes only. Please consult a physician for specific treatment recommendations.

Owner's Manual: Nutrition Care for Your Kidney Transplant