On 18th November 2014 ten years since the first liver transplantation in Bulgaria were celebrated. The road of Bulgarian liver transplant surgery was revealed exactly before ten years.

Our Dr. Stoyanova, resident in gastroenterology is actively engaged in these patients before and after transplantation. So, beginning with this article, we start to publish specific materials about the lifestyle of this group of patients every week.

Proper nutrition is quite important in the recovery process after liver transplantation.

A healthy diet includes fruits, vegetables, wholegrain foods, dairy products with low fat content or without fat, lean meat, domestic birds (chicken, turkey), fish, eggs, nuts and beans. It should be prepared with low content of saturated fats, trans fats, salt, added sugar and cholesterol.

After liver transplantation the patients need food rich in calories and proteins for muscle and tissue restoration. The dietary requirements are different in each case.

Some patients have problems with their nutrition in the first weeks following surgery due to loss of appetite or altered taste. This is a frequent condition and the problem is solved over time with patients’ recovery and their increased physical activity.

Here are several useful advices if you have problems with nutrition:

  • If you have poor appetite, try to have several but smaller meals with middle courses in between. Choose foods with high protein content and/or drink high caloric liquids, like milk or juice.
  • If you feel full and bulging, try to eat more frequently with small amounts and avoid foods which lead to additional gas formation. So, consume these with high carbohydrate and protein content, but not fat, and drink liquids between the courses not during them.
  • If you have nausea, consume more carbohydrates like pasta for example, cereals, bread, crackers and fruits – these can help.

Nausea can be diminished with drinking ginger tea and lemon water.

  • If you have impaired taste, try to use spices to improve the taste of food.

Most of the patients should not follow restrictions concerning eating after transplantation. The recommendations are almost the same as in people trying to eat healthy. If you have other health problems like elevated blood sugar or high blood pressure, your doctor will give you special instructions for your diet.

Following a certain diet, taking food additives and vegetable products should be avoided.

The concentration of some immunosuppressants is influenced when grapefruit is eaten or consumed as a juice. All transplant centers recommend the patients to avoid consuming grapefruit in all its forms and all drinks containing grapefruit juice in significant quantity especially if they take cyclosporine or tacrolimus.

Although it is important to regain the lost kilograms, your weight should be kept in normal range in regard to your height. Overweight can contribute to other health complications like heart problems and diabetes.

Patients after liver transplantation often have high blood levels of potassium. This hyperkalemia can be due to the immunosuppressants or renal dysfunction. It can lead to irregular pulse. If your potassium level is high, it will be controlled with a drug called fludrocortisone and/or dietetic restrictions of foods with high potassium content.


Foods with high concentration of potassium are:

apricots, bananas, melons, dates, dried fruits, figs, kiwi, nectarines, oranges, prunes, raisins, artichokes, beans, Brussels sprout, lentils, peas, potatoes, pumpkin, spinach, squash, tomatoes, tomato sauce, ketchup, cocoa, coffee, nuts, cereals with fruits and nuts, salt substitute.

Physical activity

Exercises improve your overall health. They will make you feel better and help managing stress. Regular practice maintains your optimal weight and prevents bone diseases (osteoporosis). Every physical activity you can perform is beneficial. Walking, swimming, cycling, weightlifting, golf or tennis, yoga practice or even housework are all examples of good training.

Staying active is crucial for full living. If you have been in hospital for a long time, you could have lost muscle mass from the long bed rest. Your circadian rhythm (sleep-wake cycle) may be impaired as well. Regular exercises and proper nutrition will return you more easily to the routine. In the first six months after surgery it is good to avoid heavy and intense physical activities with high risk of injuries like soccer, wrestling, skiing, water skiing or motorcycling. The best activity in this period is walking on air in the nature.