Most liver transplant patients have to avoid certain foods after their surgery. Your dietary restrictions after liver transplant will depend to some extent on what complications, if any, you have after the surgery. Immediately following transplant, your diet may be more restricted than it might be after recovery from the surgery. Many of the dietary restrictions relate not to the surgery itself but to the immunosuppressive medications you take to prevent rejection of your new organ.
Avoiding Grapefruit
A substance in grapefruit interferes with the enzyme CYP3A4, which breaks down medications. Grapefruit can interact with several anti-rejection medications, including tacrolimus and cyclosporine. CYP3A4 breaks down the drug so you absorb less of it. When you consume grapefruit or fruits such as Seville oranges, you may absorb a larger than normal dose of your anti-rejection drug, resulting in an overdose. For this reason, many transplant patients must avoid products containing grapefruit altogether.
Watching Carbohydrate Intake
In the first few weeks after transplant, most patients take corticosteroids along with other drugs to suppress the immune system. In high doses, corticosteroids raise your blood sugar. After liver transplant, as many as 31 percent of patients may develop diabetes, according to a French study reported in the June 2003 issue of "Transplant Proceedings." Restricting your simple sugar intake will not only allow you to fill up on the more healthy choices you need to rebuild new tissues, such as lean protein, but will also help keep your blood glucose low.
Listeria
When you take high doses of anti-rejection drugs, you have an increased susceptibility to infection. A bacterial infection called listeria can hit transplant patients especially hard, with a mortality rate of 26.7 percent in a Spanish study reported in the September 2009 issue of "Clinical Infectious Diseases." The Centers for Disease Control and Prevention advises avoiding soft or unpasteurized cheeses, cooking deli meats and hot dogs thoroughly before eating and not consuming refrigerated pate or smoked seafood unless it's in a cooked dish.
Alcohol
If you needed a liver transplant because you had cirrhosis of the liver caused by alcohol, you need to avoid alcohol for the rest of your life. Alcoholism is a lifelong disease that could recur if you start drinking again. If you have hepatitis B or C, you should also avoid alcohol, which could accelerate liver damage that could occur from the virus after transplant. Unless the virus is successfully treated, it may attack your new liver. Not drinking protects your liver from an additional source of potential damage.
References
- The Leeds Teaching Hospital: Caring for a Post Liver Transplant Patient
- "Clinical Infectious Diseases"; Risk Factors, Clinical Features, and Outcomes of Listeriosis in Solid-Organ Transplant Recipients: A Matched Case-Control Study; N. Fernàndez-Sabé et al.; September 2009
- The Harvard Medical School Family Health Guide: Grapefruit and Medication: A Cautionary Note
- "Transplant Proceedings"; Diabetes Mellitus After Liver Transplant New Etiologic Clues and Cornerstones for Understanding; S. Tueche; June 2003
- Centers for Disease Control and Prevention: Listeriosis
- UpToDate.com; Hepatitis C; Peter Bonis, M.D., S. Chopra, M.D.; June 2011
