Register or Submit a manuscript.
Quick Link
OBM Transplantation

(ISSN 2577-5820)

OBM Transplantation (ISSN 2577-5820) is an international peer-reviewed Open Access journal published quarterly online by LIDSEN Publishing Inc., which covers all evidence-based scientific studies related to transplantation, including: transplantation procedures and the maintenance of transplanted tissues or organs; assimilation of grafted tissue and the reconstitution of removed organs or parts of organs; transplantation of heart, lung, kidney, liver, pancreatic islets and bone marrow, etc. Areas related to clinical and experimental transplantation are also of interest.

OBM Transplantation is committed to rapid review and publication, and we aim at serving the international transplant community with high accessibility as well as relevant and high quality content.

The journal publishes all types of articles in English. There is no restriction on the length of the papers. We encourage authors to be concise but present their results in as much detail as necessary, as reviewers are expected to emphasize scientific rigor and reproducibility.

 
 

Publication Speed (median values for papers published in 2024): Submission to First Decision: 6.7 weeks; Submission to Acceptance: 14.4 weeks; Acceptance to Publication: 4 days (1-2 days of FREE language polishing included)

 
 
Current Issue: 2026  Archive: 2025 2024 2023 2022 2021 2020 2019 2018 2017
Open Access Editorial

Nutrition and Transplant Outcomes

Mohammed H. Moghadasian 1,2,*

  1. Department of Food and Human Nutritional Sciences, University of Manitoba, Winnipeg, Canada

  2. Canadian Centre for Agri-Food Research in Health and Medicine, St. Boniface Hospital Research Centre, Winnipeg, Canada

* Correspondence: Mohammed H. Moghadasian

Special Issue: Diets and Transplantation: Clinical and Experimental Evidence

Received: January 27, 2026 | Accepted: January 27, 2026 | Published: February 12, 2026

OBM Transplantation 2026, Volume 10, Issue 1, doi:10.21926/obm.transplant.2601266

Recommended citation: Moghadasian MH. Nutrition and Transplant Outcomes. OBM Transplantation 2026; 10(1): 266; doi:10.21926/obm.transplant.2601266.

© 2026 by the authors. This is an open access article distributed under the conditions of the Creative Commons by Attribution License, which permits unrestricted use, distribution, and reproduction in any medium or format, provided the original work is correctly cited.

Abstract

Dietary guidelines and Nutrient Reference Intakes are important tools for maintaining optimal health in the general population. Similar guidelines have also been developed by specific organ health associations to help their patient populations recover from disorders or prevent/delay clinical events and subsequent complications. However, there are no specific national and international guidelines to provide dietary and nutrient intake recommendations peri-transplantation. The complex nature of transplantation and insufficient high-quality data are among the factors limiting the establishment of such dietary and nutritional guidelines. Therefore, individualized nutritional care seems to be the best strategy peri-transplantation. In this regard, strong cooperation of involved partners, including the patients and their family members/caregivers plus their healthcare providers, along with nutrition knowledge, plays a crucial role. The ultimate goal is to take advantage of the provision of adequate high-quality nutrients to facilitate a faster wound healing process and recovery from surgical procedures, prevent acute infection post-transplantation, reduce the length of hospitalization, and prevent/postpone the onset of post-transplantation metabolic morbidities. Altogether, an optimal nutritional status will help to reduce the complications associated with transplantation and relevant therapies, enhancing survival rates of donor organs. Special considerations should be given to possible interactions between dietary agents and drugs to ensure minimal damages to the “gift-of-life” and maximal rates of a long-term survival.

Keywords

Nutrition; nutrients; transplantation; organ function; survival

1. Introduction

Optimal nutrition plays a crucial role in the survival and physiologic function of donor organs and the overall health and performance of transplant recipients in many ways. Despite this important role of nutrients on transplantation outcomes, there are no established guidelines in this regard. In fact, post-transplant nutritional management is highly individualized, and therefore, general guidelines may not be applicable. Furthermore, many other factors involved in the process of giving and receiving solid organs make reaching a consensus on specific nutritional recommendations very difficult. Among these factors the conditions of the gift organ, the type of organ (kidney, heart, liver, etc.) being transplanted, the overall health and nutritional status of recipients pre-transplantation, the duration of the waitlist, the nature of surgical procedures, the drug therapy strategies, the availability of skilled dieticians, the nutrition knowledge of the health care providers and caregivers, and perhaps the availability and affordability of appropriate nutritious diets and supplements can be named. Additionally, a lack of sufficient high-quality data from large, well-designed randomized clinical trials makes such a guideline establishment less achievable. The aim of this editorial is to provide a summary of current knowledge and share and discuss the experiences of international members of solid organ transplant communities.

2. The Importance of Optimal Nutrition during Waitlist

Less than optimal nutritional status is a common feature among subjects waiting for solid organ transplantation. Analyses of nutritional assessment data in 74 subjects waiting to receive liver transplants showed that all of these subjects-to a varying degree-suffer from nutritional imbalance, independent of the type of their liver disease [1]. Other subjects waiting for kidney transplants also were reported to be malnourished, which negatively impacted post-transplant outcomes [2]. This retrospective observational study of 140 kidney transplant subjects reported that patients with a malnourished status pre-operation-as assessed by the Geriatric Nutritional Risk Index or Nutritional Risk Index-had a longer hospitalization period and higher rates of post-operation infection as compared with subjects with a better nutritional status pre-operation [2]. In order to improve pre-operative nutritional status in subjects awaiting kidney transplantation, Losappio et al. [3] suggested consumption of the Mediterranean Diet due to its beneficial effects on intestinal microflora and overall anti-inflammatory properties. Another study investigated the effects of vitamin D status pre-operation on the outcomes of lung transplantation in 219 patients [4]. This study reported a significantly negative association between serum vitamin D levels as well as overall nutritional status-as assessed by the Nutritional Risk Screening 2002 Score-with the duration of hospital stay, including the intensive care unit and higher infectious complications. Likewise, nineteen male patients out of 31 subjects awaiting liver transplantation were diagnosed with malnutrition [5]. Lower levels of calcium, magnesium, and selenium were found in almost all of these subjects (93-100%); although manganese levels were above normal range. Another study [6] reported that adequate nutrient intakes while on the waitlist for liver transplantation will reduce metabolic risks, including sarcopenia, and significantly enhance transplantation outcomes. The authors suggested that nutritional support can be provided through normal diets, enteral nutrition, supplements, and other means after consultation with skilled dietitians. Pre-operative nutritional assessments and body cell mass measurements were used to assess the impact of these measures on the outcomes of liver transplantation in 50 subjects [7]. A lower body cell mass index was significantly associated with a higher incidence of post-operation infection and in-hospital death rates among these patients.

3. Post-Transplantation Nutritional Impact

An optimal nutritional status after transplantation provides several benefits. Primarily, it will facilitate wound healing and faster recovery with fewer complications. Although this issue is not specific to transplantation procedures, it is very important to enhance wound healing and full recovery in the acute phase of post-transplantation complications; in turn, this benefit will lead to reductions in the risk of long-term complications and graft failure. This matter is more critical for patients who waited longer and experienced a degree of malnutrition during the waiting period. The extent of malnutrition may be related to the reasons for organ failure, the type of organ (heart, kidney, liver, etc.), the quantity and quality of nutrition support, and the relative risk for nutrient loss. Such factors in donor recipients have been discussed in detail elsewhere [8,9].

On the other hand, long-term nutritional management predominantly aims to prevent and/or postpone the onset and severity of long-term metabolic complications such as dyslipidemia, hypertension, diabetes, sarcopenia, cardiovascular disease, bone disorders, and others. A long-term optimal nutritional state post-transplantation supports the maintenance of physiologic system function, including immune function, thereby increasing the likelihood of graft survival. Additional information on this topic has been provided previously [10,11,12]. Another crucial role of a long-term optimal nutritional state post-transplantation is to facilitate physiologic rates of growth and development in children. In this regard, the importance of nutritional factors for linear growth and bone metabolism has been studied in transplant children [13,14].

4. Conclusions

The complexity of solid organ transplantation is a major challenge in the development of nutritional and dietary guidelines for peri-transplantation. However, various transplant centers have developed their own protocols to manage nutritional requirements of individual transplant candidates pre- and post-transplantation. These protocols vary significantly depending on the type of surgical procedure, the status of donor organs, the overall nutritional status of recipients prior to surgery, as well as the presence of other morbidities. Similarly, the types of early nutrition support strategies vary among transplant centers and subjects’ overall health conditions. Regardless, the goal is to provide sufficient amounts of high-quality nutrients to facilitate a faster wound healing process and prevent acute post-transplant infection, reducing the length of hospitalization. In addition to such strategies for short-term effects, long-term nutritional strategies must be implemented to prevent or delay the onset of metabolic disorders, which often develop post-transplantation. The ultimate goal is to maintain physiologic system function and enhance survival of the donor organs. In many instances-especially early post-transplantation-this goal can be achieved only through parenteral and enteral routes, while long-term goals can be achieved through the consumptions of adequate high-quality foods. A few studies have investigated the benefits of the Mediterranean Diet [15,16]. Others have highlighted the importance of adequate fruit intake, while some investigators have raised concerns about the consumption of fruits rich in simple sugars, particularly in subjects with advanced liver disease [17,18]. The roles of specific nutrients such as vitamin D, vitamin C, vitamin K, and antioxidant micronutrients have also been investigated in transplant patients [19,20,21,22,23,24]. Taken together, it seems that personalized nutritional management peri-transplantation could be the best strategy for this patient population. The initiation and maintenance of such nutritional plans requires healthcare providers with a high degree of nutrition knowledge and active cooperation from subjects and their family members or caregivers. The interactions between nutrients, dietary agents, and therapies must be carefully considered, and, if needed, appropriate modifications should be made to ensure the best physiologic environment is provided for the “gift-of-life” to survive a long time.

Acknowledgments

Support from Nikon Moghadasian in the preparation of this manuscript is greatly appreciated. The research program of MHM is supported by the Natural Sciences and Engineering Research Council of Canada (NSERC). Infrastructural support has been provided by St. Boniface Hospital Research Centre and the University of Manitoba.

Author Contributions

The author did all the research work for this study.

Funding

No specific funding was received for this work.

Competing Interests

There are no competing interests to disclose.

References

  1. DiCecco SR, Wieners EJ, Wiesner RH, Southorn PA, Plevak DJ, Krom RA. Assessment of nutritional status of patients with end-stage liver disease undergoing liver transplantation. Mayo Clin Proc. 1989; 64: 95-102. [CrossRef] [Google scholar]
  2. González García E, Arroyo T, Galván M, Becerra MJ, Gallego M, Mauro I, et al. Association Between Nutritional Status and Early Postoperative Infection Risk in Kidney Transplant Patients. Nutrients. 2025; 17: 1935. [CrossRef] [Google scholar]
  3. Losappio V, Infante B, Leo S, Troise D, Calvaruso M, Vitale P, et al. Nutrition-based management of inflammaging in CKD and renal replacement therapies. Nutrients. 2021; 13: 267. [CrossRef] [Google scholar]
  4. Lee HJ, Park M, Lee S, Hong SK. Clinical effect of preoperative 25-OH-vitamin D3 level in liver transplant recipients. Transplant Proc. 2022; 54: 2301-2306. [CrossRef] [Google scholar]
  5. Guerra TS, Hoehr NF, Boin ID, Stucchi RS. Trace elements in plasma and nutritional assessment in patients with compensated cirrhosis on a liver transplant list. Arq Gastroenterol. 2016; 53: 84-88. [CrossRef] [Google scholar]
  6. Hammad A, Kaido T, Aliyev V, Mandato C, Uemoto S. Nutritional therapy in liver transplantation. Nutrients. 2017; 9: 1126. [CrossRef] [Google scholar]
  7. Kaido T, Mori A, Oike F, Mizumoto M, Ogura Y, Hata K, et al. Impact of pretransplant nutritional status in patients undergoing liver transplantation. Hepatogastroenterology. 2010; 57: 1489-1492. [Google scholar]
  8. Hasse JM. Nutrition assessment and support of organ transplant recipients. J Parenter Enter Nutr. 2001; 25: 120-131. [CrossRef] [Google scholar]
  9. Siegel C, Arnon R, Florman S, Bucuvalas J, Oishi K. Nutritional management and biochemical outcomes during the immediate phase after liver transplant for methylmalonic acidemia. Nutrients. 2020; 12: 2976. [CrossRef] [Google scholar]
  10. Hasse JM. Diet therapy for organ transplantation: A problem-based approach. Nurs Clin N Am. 1997; 32: 863-880. [CrossRef] [Google scholar]
  11. Wilson NK, Kataria AD. Immunosuppression in solid organ-transplant recipients and impact on nutrition support. Nutr Clin Pract. 2024; 39: 109-116. [CrossRef] [Google scholar]
  12. Spillman LN, Madden AM, Richardson H, Imamura F, Jones D, Nash M, et al. Nutritional intake after liver transplant: Systematic review and meta-analysis. Nutrients. 2023; 15: 2487. [CrossRef] [Google scholar]
  13. Mager D, Al-zaben AS, Robert C, Gilmour S, Yap J. Bone mineral density and growth in children having undergone liver transplantation with corticosteroid-free immunosuppressive protocol. J Parenter Enter Nutr. 2017; 41: 632-640. [CrossRef] [Google scholar]
  14. Pawlowska J, Socha P, Jankowska I. Factors affecting catch-up growth after liver transplantation in children with cholestatic liver diseases. Ann Transplant. 2010; 15: 72-76. [Google scholar]
  15. López-Méndez I, Uribe M, Juárez-Hernández E. Immunonutrition: Another player on the MASLD field. Int J Mol Sci. 2025; 26: 8928. [CrossRef] [Google scholar]
  16. Vučković M, Radić J, Gelemanović A, Bučan Nenadić D, Kolak E, Radić M. Associations between depression, nutritional status and Mediterranean diet in Dalmatian kidney transplant recipients. Nutrients. 2021; 13: 4479. [CrossRef] [Google scholar]
  17. Boslooper-Meulenbelt K, Patijn O, Battjes-Fries MC, Haisma H, Pot GK, Navis GJ. Barriers and facilitators of fruit and vegetable consumption in renal transplant recipients, family members and healthcare professionals-A focus group study. Nutrients. 2019; 11: 2427. [CrossRef] [Google scholar]
  18. Parisse S, Carnevale S, Di Bartolomeo F, Poli E, Miceli F, Ferri F, et al. A low daily intake of simple sugars in the diet is associated with improved liver function in cirrhotic liver transplant candidates. Nutrients. 2023; 15: 1575. [CrossRef] [Google scholar]
  19. Doi J, Moro A, Fujiki M, Eghtesad B, Quintini C, Menon KN, et al. Nutrition support in liver transplantation and postoperative recovery: The effects of vitamin D level and vitamin D supplementation in liver transplantation. Nutrients. 2020; 12: 3677. [CrossRef] [Google scholar]
  20. Battaglia Y, Cojocaru E, Fiorini F, Granata A, Esposito P, Russo L, et al. Vitamin D in kidney transplant recipients. Clin Nephrol. 2020; 93: 57-64. [CrossRef] [Google scholar]
  21. Medeiros PJ, Lima MA, Souza KS, Andrade CE, Ururahy MA, Almeida JB, et al. Vitamin D status and biomarkers of renal graft function after kidney transplantation: A longitudinal study. Nutr Hosp. 2023; 40: 412-418. [Google scholar]
  22. Borran M, Dashti-Khavidaki S, Alamdari A, Naderi N. Vitamin C and kidney transplantation: Nutritional status, potential efficacy, safety, and interactions. Clin Nutr ESPEN. 2021; 41: 1-9. [CrossRef] [Google scholar]
  23. Fusaro M, Cosmai L, Evenepoel P, Nickolas TL, Cheung AM, Aghi A, et al. Vitamin K and kidney transplantation. Nutrients. 2020; 12: 2717. [CrossRef] [Google scholar]
  24. Tuokkola J, Anderson CE, Collins S, Pugh P, Vega MR, Harmer M, et al. Assessment and management of magnesium and trace element status in children with CKD stages 2-5, on dialysis and post-transplantation: Clinical practice points from the Pediatric Renal Nutrition Taskforce. Pediatr Nephrol. 2025; 40: 3301-3323. [CrossRef] [Google scholar]
Journal Metrics
2024
CiteScore SJR SNIP
0.40.1310.065
Newsletter
Download PDF Download Full-Text XML Download Citation
0 0
Newsletter  

TOP