Diet After Transplantation

Diet After Transplantation

DIET AFTER TRANSPLANTATION

by Peggy Harum, RD, CS,
LD

Peggy Harum, RD, CS, LD is a certified specialist

in renal nutrition who works for Total Renal Care.

Before I prepared this article, I did some

reviewing of different papers that had covered the topic of diet after transplant. I was

surprised to learn that noncompliance with immunosuppressant medications is responsible

for almost a third of graft loss. Nearly half of transplant centers exclude patients with

a history of noncompliance from receiving a living-related kidney. I am not sure that our

patients really believe this, but apparently it is true.

I have heard presentations by dietitians that

caution patients to expect a 25-pound weight gain during the first year after the

transplant. Unfortunately, there is such happiness with the idea of being free of dialysis

that the patient really does not want to have to worry about a diet.

Even more amazing is that some of the largest

transplant centers in the U.S., including the one in Miami, Jackson Memorial Hospital, do

not teach diet after transplantation. The idea of a "diet" must be addressed.

Unwanted weight gain, high blood pressure, or high cholesterol/high triglycerides may

develop, if this topic is ignored. I note there is even a form of diabetes,

steroid-dependent diabetes, which can develop from incautious use of the steroids

prescribed after a transplant.

Temporarily, certain changes may occur such as

high potassium levels, or low serum phosphorus levels. The transplanted person may need

high-calcium, high-phosphorus foods, the same he or she had to avoid while on dialysis.

The patient may need to follow a low salt, low fat diet. Remember that FAST FOODS are high

salt, high fat and high calories.

High blood cholesterol levels may increase the

risk of coronary heart disease, so it is wise to consider reducing the fat in your diet.

Your cholesterol level should be less than 200 milligrams per deciliter (mg/dL and your

HDL (the good cholesterol) should be more that 35mg/dL. Buy a low fat cookbook. Start

reading labels.

I hate to be the bearer of bad tidings, but it is

better to know ahead of time what you are in for with the huge surge in appetite - that

way you can prepare! So what I am suggesting is:

1. Be aware that weight gain will probably occur.

2. Ask to see the dietitian (even if you are not

referred) when you are hospitalized for the transplant. That way you can begin adjusting

to the idea.

3. Save yourself a lot of trouble by starting

with diet changes before your transplant.

4. Begin a daily walking program. Start with 15

minutes, then 30 minutes. It is possible to walk two miles a day in 30 minutes. (I know

because I do it.) During the summer, go early in the morning or late in the evening.

5. Start thinking of minor dietary changes you

can learn to live with—and practice them.

Examples: Switch from regular soda to diet soda.

Broil or bake meats, fish and fowl instead of frying. Learn to use sugar substitutes

instead of sugar. Reduce the margarine, butter, oil and fats in your diet. Have

"EMERGENCY SNACKS" ready, so you will not grab the high calorie foods.

6. Buy a scale and weigh yourself every morning

at the same time, same place and in the same clothes.

Note: This article appeared in

"Renalife," Vol. 12, No. 3, Winter 1997, published by the American Association

of Kidney Patients. Reprinted with permission.