Nutritional program for heart transplantation.
Methodist Hospital has completed 52 heart transplants during its 4 1/2-year history. Dietary restrictions for patients have been deemed necessary to offset the side effects from medication. The purpose of this article is to provide information regarding the nutritional program for heart transplant recipients. Evaluation of the dietary program, changes made, and problems encountered are discussed. The first 10 patients were instructed on a type IIA hyperlipoproteinemia (300 mg cholesterol), no concentrated sweets, and 2 to 4 gm sodium-restriction diet with no fresh fruit or vegetables for 6 weeks after the transplantation. These patients had limited follow-up dietary instruction. Of these patients, 50% (five of 10) gained 50 pounds or more above their pretransplant and/or desirable weight; two died within 1 year, and another two within 18 months with accelerated coronary atherosclerosis documented at autopsy. These results were considered unacceptable. The current diet after heart transplantation is 200 mg cholesterol, low saturated fat, low total fat, high fiber, 4 to 5 gm sodium, with limited concentrated sweets. The goals of this diet are discussed. Patients receive nutritional assessment before and after transplantation, care monitoring, and individualized dietary instruction, as well as outpatient follow-up done by the transplant team dietitian as needed. Of these patients, 20% (five of 25) gained 50 pounds or more, and one died with arteriosclerotic-related complications within the first year. The patient's nutritional status before transplant, previous eating habits, educational level, consistency in physician and team member reinforcement of diet are all major factors in long-term compliance.
Ragsdale
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Department of Nutrition and Dietetics, Methodist Hospital of Indiana, Inc., Indianapolis 46202.
D000328:Adult; D003524:Cyclosporins / Q000009:adverse effects; D005260:Female; D016027:Heart Transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D009747:Nutritional Physiological Phenomena; D010353:Patient Education as Topic; D011182:Postoperative Care; D011300:Preoperative Care
D003524:Cyclosporins