MNT for Organ Transplant Flashcards
What type of organ transplant is the most common?
Kidney
What is the indication of organ transplantation?
Decompensated end-stage organ failure
What are some examples of diseases in which organ transplants are indicated?
-End-stage liver disease
-End-stage renal disease
-Congestive heart failure
-Respiratory failure due to COPD or CF
What are some contraindications of organ transplant?
-Active infection or sepsis
-Multisystem organ failure
-Active substance abuse
-Advanced age
-Frailty
-Severe obesity
-Lack of social support post-transplant
-Poor prognosis
In the pre-transplant phase, the goals of MNT are…
-Optimize nutritional status as much as possible prior to transplant
-Alleviate complications caused by organ failure
Many patients awaiting transplant are _____, and this can cause higher rates of post-transplant morbidity and mortality
Malnourished
Medical concerns in the 1st 2 months after transplant include…
-Rejection
-Infections
Nutrition concerns for the 1st 2 months post-transplant:
-Provide adequate nutrition to replete stores, heal surgical wounds, and fight infections
-Food-drug interactions of immunosuppressive regimen
Food-drug interactions of Cyclosporine:
-Avoid grapefruit
-Hypomagnesemia
-Hyperkalemia
-Hyperglycemia
-Hypertension
-Hyperlipidemia
Food-drug interactions with Tacrolimus (Prograf):
-Avoid grapefruit (causes elevated levels)
-Hypomagnesemia
-Hyperkalemia
-Hyperglycemia
-Hypertension
-N/V
Food-drug interactions with Azathioprine (Imuran):
-Macrocytic anemia
-N/V
-Mouth sores
-Acute pancreatitis
Food-drug interactions with corticosteroids (like Prednisone):
-Hyperglycemia
-Sodium retention
-Hyperphagia (increased hunger)
-Weight gain
-Hypertension
-Muscle wasting and weakness
-Impaired wound healing
-Osteoporosis
Energy needs for acute/immediate post-transplant:
30-35 kcal/kg
Protein needs for acute/immediate post-transplant:
1.5-2.0 g/kg
Fluid needs for acute/immediate post-transplant:
Individualize based on fluid status, organ function, and fluid loss
Calcium needs for acute/immediate post-transplant:
1200 mg/d
After transplant, patients should advance as tolerated to a _____ diet, considering any MNT for comorbidities
Regular
If someone has fluid retention, recommend a ____ gram sodium diet and possible fluid restriction
2
If someone has hypoglycemia, recommend a ___-___ diet
Carbohydrate-controlled
After transplant, patients should take a ____ with minerals and oral nutrition supplements if needed
Multivitamin
If someone is intubated or has a poor appetite, they might need ____ ____
Enteral nutrition
If someone needs enteral nutrition post-transplant, they should get a ____ ____ formula
High nitrogen (protein)
If someone has fluid overload, they should get a _____ formula
Concentrated
If someone is one enteral nutrition, we should monitor…
-Nutritional intake
-Weight
-Labs: serum glucose, serum electrolytes
-Fluid status
-Wound healing
In the chronic post-transplant phase, what are some common nutrition concerns?
-Weight gain and obesity
-Hyperglycemia (drug-induced DM)
-Hyperlipidemia
-HTN
-Electrolyte imbalances
-Micronutrient deficiencies
-Osteoporosis
Goals of MNT for chronic post-transplant phase:
-Ensure adequate nutrition
-Prevent or treat complications
In the chronic post-transplant phase, recommend calories to promote healthy ____ ____
Body weight
Protein needs for chronic post-transplant:
1 g/kg
Someone in the chronic post-transplant stage should take a ____ with minerals
Multivitamin
Someone in the chronic post-transplant stage should get ____ mg/day of calcium
1200
What should we monitor in the chronic post-transplant stage?
-Weight
-Dietary intake
-Labs
Diet education for someone in the post-transplant stage should include…
-Heart Healthy diet
-Additional diet recommendations as needed
-Food safety
Food safety precautions:
-Avoid raw protein foods and rare meat
-Thaw perishable foods in the fridge
-Avoid using cracked eggs
-Wash fruits and vegetables
-Use only pasteurized milk and cheese
-Cook to appropriate internal temperatures
-Adhere to the expiration dates on labels
-Wash hands before handling food
