The aim of this dietary information is to explain the importance of nutrition and food safety after your kidney transplant.
Diet and your kidney transplant
One of the benefits of having a kidney transplant is that you can typically enjoy a more varied diet. However some dietary changes may be required and your kidney dietitian will guide you with this.
Immediately after your operation
A good nutritional intake will help your recovery. Eating enough of the right foods can help to prevent infections and heal wounds. If your appetite is poor after your operation, your dietitian can offer advice on how to improve your food intake or suggest nutritional supplement drinks to take.
Your transplant medications may affect your blood results and you may need to alter your diet. However this is usually short term and your dietitian will guide you through any changes.
Food safety is important to prevent any foodborne illness (food poisoning), which may result in vomiting and diarrhoea. This may cause you to become dehydrated or not absorb your transplant medications.
How do transplant medications affect my diet?
Early side effects include:
- High blood potassium level – this may occur for a short time after your transplant. If necessary, you will be advised to reduce your intake of foods high in potassium.
- Low blood phosphate level – this may occur for a short time after your transplant. If necessary, you will be advised how to increase the phosphate in your diet.
- Unstable blood glucose level – if necessary, you will be given advice to help manage this. If you have diabetes, you may also wish to discuss this with your diabetes specialist nurse or dietitian.
Longer term side effects can include:
- Weight gain – this is common, especially in the first year after your transplant. It is usually due to a combination of eating too well, lack of exercise or activity and the effect of some tablets, such as steroids.
Being overweight can lead to high blood pressure and cholesterol levels which, can lead to diabetes and heart disease. Keeping a healthy weight can help maintain the lifespan of your kidney transplant.
Back to topFood safety
Immediately after your transplant surgery, you will start taking immunosuppressive medications to prevent your body from rejecting the new kidney. These medications weaken your body’s ability to fight infection, including those that can come from food. It is important to prevent foodborne illness, as during episodes of vomiting and diarrhoea you can become dehydrated and not absorb your medications.
While food safety is especially important during the first six months after your transplant surgery, you should continue to follow food safety advice for the lifetime of your transplant.
Minimise the risk of getting foodborne illness – by following the 4 C’s
High risk foods to avoid
After your transplant you should avoid foods which put you at greater risk of a foodborne illness. The following tables list the high risk foods to avoid and safer alternatives to choose instead.
Meat and meat-free foods
Avoid
- Raw or undercooked meat or poultry
- Rotisserie chickens
- Meat or poultry from open deli counters
- Cured meats eg salami, parma ham, chorizo, pepperoni
- Meat and vegetable pâtés
- Fermented meat-free alternatives e.g. Tempeh
Alternative
- Well-cooked meat and poultry
- Tinned meat
- Pre-packaged cooked meats and poultry stored and used according to manufacturer’s instructions
- Cured meats if cooked until piping hot
- Tinned pâtés
- Pasteurised and cooked tofu
Fish
Avoid
- Raw or undercooked fish and shellfish e.g. sashimi, oysters and caviar
- Sushi made with raw fish/shellfish
- Fish and shellfish from open counters
- Cold smoked fish (e.g. smoked salmon and trout) and ready-to-eat fish and shellfish, unless eaten within 24 hours of opening the packet
Alternative
- Fish and shellfish if cooked until piping hot
- Tinned fish
- Sushi made with cooked fish or vegetables
- Pre-packaged fish and shellfish, stored and used according to the manufacturer’s instructions
- Cold smoked fish and ready-to-eat fish that is eaten within 24 hours of opening the packet
Eggs
Avoid
- Raw or undercooked eggs
- Sauces, dressings and desserts made with raw eggs e.g. homemade mayonnaise, aioli, hollandaise and béarnaise sauces, caesar salad dressing, chocolate mousse, egg-nog, uncooked meringue
Alternative
- Use lion stamped eggs and cook well
- Shop bought mayonnaise
- Products made with pasteurised egg
Dairy and plant-based alternatives
Milk and Cream
Avoid
- Raw or unpasteurised dairy milk e.g. milk sold on local farms
- Unpasteurised plant-based milks e.g. soya, rice or nut milks
- Unpasteurised cream
Alternative
- Pasteurised dairy milk (cow. goat or sheep), UHT milk
- Pasteurised plant-based milks e.g. soya, rice or nut milks
- Pasteurised cream e.g. double, single, soured cream, crème fraiche
Cheese
Avoid
- Unpasteurised soft cheeses, unless cooked until piping hot
- Homemade cheese e.g. labneh/paneer
- Dolcalette
- Soft cheeses (mould-ripened/ white rind) eg brie, camembert and some goat’s cheese e.g.chevre
- Blue-veined cheeses, unless cooked until piping hot e.g. Danish Blue, gorgonzola, Roquefort
- Cheeses from open deli counters
Alternative
- Pasteurised soft cheeses (check the label e.g. cottage cheese, mozzarella, feta, cream cheese, ricotta, halloumi, hard goat’s cheese, paneer and labneh
- Hard cheeses (pasteurised and unpasteurised) e.g. cheddar, red Leicester, edam, gouda, stilton, pecorino and parmesan
- Processed cheeses e.g. cheese spreads, mould-ripened and blue-veined cheeses, if cooked until piping hot.
- Vegan cheeses made from coconut oil, soya or cashews. It is best to buy pre-wrapped cheese.
Yogurt and ice-cream
Avoid
- Homemade yogurt and home starter yoghurt kits
- Unpasteurised yoghurt
- Yoghurt described on the label as ‘bio’ or ‘probiotic’ (e.g. Onken, Yeo Valley, Rachel’s, Activia)
- Probiotic drinking yoghurt e.g. Yakult, Actimel, Supermarket own
- Fermented milk drinks e.g. Kefir
- Ice cream from ice cream vans and soft serve machines e.g. whipped ice cream
- Homemade ice cream using raw eggs
Alternative
- Yoghurt that is not described as ‘bio’ or ‘probiotic’ e.g. live, natural, Greek and fruit yoghurts (e.g. Muller, supermarket own, lassi)
- Prebiotic yoghurt or products (these contain substances which promote the growth of healthy bacteria. They do not contain any live bacteria themselves)
- Shop bought tubs of ice cream stored and consumed according to manufacturer’s instructions
- Homemade ice cream using pasteurised egg or an egg-free recipe
Fruit and vegetables
Avoid
- Unwashed fruits, vegetables and salad
- Unpasteurised fruit juice and smoothies
- Raw sprouted seeds e.g. beansprouts
- Fermented vegetables e.g. sauerkraut and kimchi
Alternative
- Wash all fruit, vegetables and salad
- Pasteurised fruit juice and smoothies
- Thoroughly cook sprouted seeds e.g. beansprouts
- Cooked fresh, frozen or canned vegetables
Miscellaneous
Avoid
- Ready-to eat sandwiches that contain high risk foods eg cured meat or smoked salmon
- Reheated cooked rice and rice dishes
- Fermented beverages e.g. kombucha
Alternative
- All pre-packaged sandwiches stored and consumed according to manufacturer’s instructions
- Freshly cooked rice served immediately
- Instant and brewed coffee and tea
If you have a question about any food that is not on the above lists, please ask to see your dietitian.
Eating out and takeaways
Eating out and take-away meals should be avoided for the first six to eight weeks after your transplant. After this time, eating out can be enjoyed if following food safety advice.
Every business selling food will be given a food hygiene rating issued by the local authority. This provides guidance on the overall cleanliness of a business and whether it is a suitable place to eat. The Food Standards Agency website https://ratings.food.gov.uk list all the ratings and a mobile phone app is also available.
Choose restaurants with a high, or level 5, food hygiene rating and decide on menu options using the guidance in this booklet. Caution should be taken when eating foods from buffets, street vendors, deli counters and salad bars due to the risk of cross-contamination.
Tips to enjoy eating out safely
- Check the eating area is clean and tidy
- Avoid all high-risk foods on the menu or enquire if unsure
- Try to order a plated meal that is cooked fresh to order
- Avoid foods from salad bars and deli counters
- Ensure your meal is piping hot and thoroughly cooked when it arrives
- Avoid rice that has already been cooked; ask for it to be cooked fresh or choose another option such as potato, pasta, chips, chapatti or noodles
- Beef burgers should be well done, even if freshly made, as there is a risk of food poisoning with minced/ground beef if not cooked thoroughly
- If you need to eat from a buffet it is recommended to try to be first in the queue and not to go back for further servings as there is a risk the food may have been contaminated by other diners.
In the long term
Weight gain is common after a transplant. This is due to relaxed dietary restrictions and a general sense of well-being, as well as potentially steroid-induced hunger. Most weight gain has been found to occur during the first 6-12 months after transplantation. Keeping a healthy weight can help maintain the lifespan of your kidney transplant.
A healthy diet includes eating foods which are low in fat, sugar, salt and high in fibre. In particular, continue to be careful with the amount of salt you eat to help manage your blood pressure. Including enough calcium in your diet is also important to keep your bones healthy and reduce the risk of osteoporosis. You may be referred to a dietitian for advice if your intake of calcium is low.
If you require further information about your diet please speak with your transplant team who can refer you to a kidney dietitian.
Frequently asked questions
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If you have any suggestions,comments or queries regarding this information please let your dietitian know.
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