Good nutrition is an important part of your complete recovery following liver transplant. As you recover, your body has increased nutritional needs for wound healing to regain any weight you lost due to liver disease and the stress of surgery and to help your body fight infection. Dietary requirements are different for everyone, so your dietician will meet with you after transplant to discuss your specific nutritional and caloric needs and any dietary restrictions you may have. Most patients will need to increase calories as well as calcium and protein intake. Some patients may have to limit intake of sugar, salt (sodium) or potassium-containing foods.

Transplant recipients may also be at greater risk for bone fractures due to poor nutrition before transplant, chronic liver disease or long-term use of steroids (prednisone). A bone density test may be ordered to check for calcium loss and weakness in your bones. Your physician and dietician may recommend that your take calcium supplements and increase your dietary intake of calcium. Good sources of calcium include: yogurt, low fat milk products (ricotta cheese, skim or low-fat milk, provolone cheese, mozzarella cheese), sardines, salmon, dark green leafy vegetables and calcium-fortified orange juice. Regular exercise will also help prevent bone weakness.

During the first few weeks after transplant you may have some trouble eating due to loss of appetite, feeling full or nauseated, or you may have changes in taste. This is quite common and will resolve over time as you recover and your activity increases. While your appetite is low, you might try eating several small meals a day, snack between meals on high calorie and high protein foods and/or drink higher calorie liquids such as milk or juice rather than water. Your dietician can help you plan your meals and snacks. If you feel full or bloated, try to eat frequent small meals, avoid foods that may cause additional gas, eat foods that are high in carbohydrates and proteins rather than fats, or sip on fluids between meals instead of during meals. If you are nauseated during your recovery, foods high in carbohydrates such as pasta, cereal, bread, pretzels and fruit may help. Nausea may also be decreased by drinking ginger ale and lemon-lime sodas. Spicy and fatty foods should be avoided if you are nauseated. If you continue to have problems with nausea, your physician may order a medication to help decrease this feeling. If you are experiencing changes in taste, try using seasonings and spices to enhance the flavors of your food. Marinating meat, poultry or fish can also be helpful. If you continually have a bad taste in your mouth, drinking cold fluids or sucking on hard candies may also help.

Patients often have high potassium levels in their blood following liver transplant. An increased potassium level (hyperkalemia) could be due to ant-rejection medications or kidney dysfunction. High levels of potassium may cause the heart to beat irregularly. If your potassium level is high, it will be controlled by a medication called fludrocortisone (Florinef^®) and/or dietary limits of high-potassium foods. Some high potassium-containing foods include: apricots, bananas, cantaloupes, dates, dried fruits, figs, honeydew, kiwi, nectarines, oranges, prunes, raisins, artichokes, beans, brussel sprouts, lentils, peas, potatoes, pumpkin, spinach, squash, tomatoes, ketchup, cocoa, coffee, nuts, cereals with fruits and nuts, and salt substitute. You dietician will advise you on how many servings of these foods you may have daily if your potassium level is high.

While it is important to regain lost weight and to rebuild your protein stores, you should also be careful not to gain too much weight once you have returned to your recommended weight. Being overweight may contribute to other health complications such as heart disease and diabetes. Regular low-impact exercise such as walking or riding a bicycle can be very helpful. You should start all activities slowly then gradually increase your activity as your endurance improves.