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A liver transplant is a life-saving procedure that removes your diseased liver and replaces it with a new liver from a donor. It’s a major surgery that requires lifelong changes to protect your new liver and keep yourself healthy. After liver transplant surgery, eating a healthy diet and avoiding foods that can make you sick is crucial.

Learn why nutrition is vital to your recovery and what you should eat — and avoid — after a liver transplant.

Post-Transplant Health Risks

After you receive a new liver, there’s a chance that your immune system will reject it. Taking antirejection medications (immunosuppressants) will reduce that risk. The risk is highest in the first six months, but you’ll have to take the medicine for the rest of your life.

The medications can save your liver, but they have potential side effects. They work by weakening your immune system, but that makes you more susceptible to infections and illnesses. They can also cause these long-term health problems.

• Brittle bones that break easily.
• Diabetes or high blood sugar.
• High blood pressure.
• High cholesterol or triglyceride levels.
• Kidney damage.
• Weight gain.

A healthy diet and lifestyle can help prevent or manage these long-term side effects.

What to Eat After a Liver Transplant

A healthy, balanced diet is vital after your transplant. Eating well will help your body heal and give you more energy to resume exercise and regular activities. A healthy diet may also reduce your risk of complications.

You won’t have to eat special foods, but you should choose foods that are low in:

• Saturated or trans fats. These unhealthy fats can raise cholesterol and increase your risk of heart disease. They can also promote inflammation that might harm your liver or affect your healing. Red meat, cheese or high-fat dairy foods, fast foods, and packaged snacks or desserts are high in these fats.

• Sodium. Too much sodium can raise your blood pressure, cause you to retain fluid, and stress your kidneys. Processed and packaged foods are high in sodium, so limit these and choose fresh, whole foods instead.

• Sugar. Excess sugar promotes weight gain and may contribute to diabetes. It can also affect how your body heals after surgery. Look out for added sugar in foods and drinks — and satisfy your sweet tooth with fruit instead of desserts.

The dietitian on your transplant team will provide any specific diet instructions. They will also help you plan a diet with foods you enjoy eating. In general, you should aim for:

• Five or more servings of colorful fruits and vegetables each day. These provide vitamins and minerals that are essential for a healthy liver. They’re also high in fiber which helps your digestive tract work better and makes it easier to maintain a healthy weight. Citrus fruits, berries, leafy greens, broccoli, cauliflower, and bell peppers are excellent choices.

• Several servings daily of complex carbohydrates like oats, shredded wheat, brown rice, quinoa, beans (legumes), or sweet potatoes. These help stabilize your blood sugar and provide a long-lasting form of energy. Limit refined carbohydrates like white pasta, bread, rice, or sweet baked goods as much as possible.

• Three or more servings of lean proteins each day. Protein is vital for tissue repair after surgery and over the long term. Choose poultry, seafood, pork tenderloin, beef sirloin, nonfat Greek yogurt or cottage cheese, tofu, lentils, chickpeas, or other beans.
• Three or more daily servings of calcium-rich foods. These can help protect your bones from osteoporosis (brittle bones), a potential side effect of post-transplant drugs. Excellent choices include nonfat regular or calcium-fortified plant milk, nonfat yogurt or cottage cheese, almonds, figs, and tofu.
• Healthy fats from oily fish (like salmon), olive oil, nuts, seeds, and avocados. These can help reduce cholesterol and blood pressure and are heart-healthy. They also have anti-inflammatory benefits, which help with healing and may protect your heart over time.

• At least eight cups of fluid every day. Proper hydration supports overall health, and it’s essential for liver function. Aim to drink plenty of fluids throughout the day, primarily water. Limit sugary beverages, coffee, and alcohol, as these can strain your liver and possibly interact with medications.

Your doctor or dietitian may also recommend special vitamins or supplements such as calcium and vitamin D for your bones.

Food Safety Tips

It’s crucial to take steps to avoid food poisoning after a transplant. Immunosuppressant drugs purposely weaken your immune system so your body doesn’t attack the donated organ. But this weakening of the immune system makes you more susceptible to bacterial and viral infections, including food poisoning.

These tips can reduce the risk of a foodborne illness:

• Always wash your hands before and after handling food. And make sure food service workers (like at a deli counter) wear gloves when handling your food.
• Ensure your cooking surfaces and utensils are clean and sanitized after use.
• Wash all produce under cold, running water before eating it.
• Cook meats, poultry, seafood, and eggs thoroughly. Avoid sushi, raw meat, raw oysters, or runny eggs.
• Refrigerate foods within two hours of cooking and eat them within two days.
• Avoid seed sprouts like mung, bean, or alfalfa, as well as raw honey. These can have bacteria.
• Eat and drink only pasteurized milk, cheese, or other dairy products. Bacteria can grow in raw dairy products.

The Centers for Disease Control and Prevention has information about preventing food poisoning on their website. You can also ask your doctor or dietitian. The best advice is this: When in doubt, throw it out.

What to Avoid After a Transplant

After a liver transplant, following your health care provider’s guidelines regarding dietary restrictions and potential drug-nutrient interactions is essential.

• Grapefruit and grapefruit juice can interact with certain medicines used after a transplant, so you may need to avoid these.

• Many herbal supplements can affect your liver, so don’t take these unless your health care provider approves them.

• Your doctor and dietitian will tell you if there are any other foods you should restrict. Some medications cause high potassium levels, so you may have to limit certain potassium-rich fruits and vegetables.
• You should strictly avoid alcohol because it can cause further liver damage and negatively impact your overall health.

A liver transplant is a significant procedure that requires life-long care and attention to your health. Maintaining a healthy diet is vital for a successful recovery and long-term well-being. Your health care team is to guide and support you every step of the way, so if you need help, ask.