Managing Nutritional Needs in Transplantation

Mastari Mohamad
Senior Dietitian, Institut Jantung Negara (IJN)

Transplant nutrition is a relatively new speciality. Nutrition and transplantation are inseparable. Transplant nutrition become as a speciality about 20 years and therefore is in its infancy. Future investigation and outcomes hopefully will enable to better answer questions about the association between nutrition and transplantation and assist to develop novel approaches to using nutrient specific modulation to affect transplant outcomes.

 Today kidney transplants are common, while hematopoietic stem cells (HSC) and other organ transplants are becoming more common. In IJN we have done heart transplants and lung transplants.

Transplantation is life-changing process and it requires a team effort. Transplant team usually consists of transplant surgeons, transplant specialists, transplant anesthesiologists, transplant coordinators, social workers, transplant financial counselors, dietitians, pharmacists, physiotherapists, and staff nurses. The dietitian as an integral part of the transplant team and provides clinical expertise on medical nutrition therapy. The transplant dietitian may follow a patient from pretransplant through transplant and post transplant, providing nutritional assessments, recommending nutrition support, and ensuring an appropriate nutrient intake for recovery and maintenance of health. Transplanted patients are immunosuppressed, therefore advice on foodborne infections and basic food safety guidelines should be emphasized to the patients. The education for long term health includes general health issues and comorbidities such as diabetes mellitus or hyperglicemia, weight loss or gain, hyperlipidemia and hypertension.

It is important to evaluate patients for nutritional deficiencies and aggressively replete nutritionally for successful surgical outcome and a return to optimal quality of life. Transplant continuing care should includes ongoing nutrition and behavior counseling to maintain good nutritional and health status.