Patient Guide

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Diet Guidelines for Transplant Patients

These guidelines, developed for transplant patients by SCCA dieticians, list ‘safe’ and ‘not safe’ foods to reduce your risk of infection and help you eat healthily while your immune function is limited due to chemotherapy and radiation therapy.  

These diet guidelines should be followed before and after all conditioning therapy (chemotherapy and/or radiation). Talk to your doctor and dietitian before making any changes to your diet. They will let you know when the diet is no longer required. In general, we recommend that:

  • Autologous transplant patients undergoing chemotherapy treatment only: Follow these diet guidelines during the first three months after chemotherapy or transplant. 
  • Allogenic transplant patients: Follow these diet guidelines until you are off all immunosuppressive therapy such as cyclosporine, prednisone, FK-506 (Tacrolimus), or MMF (CellCept).

Choose foods from the “Safe-to-Eat” category. Do not eat foods in the “Not-Safe-to-Eat” category. You may want to discuss the safety of these or other foods with your dietitian.

Safe-To-Eat Dairy

These dairy products are safe for you to eat:

  • All pasteurized, grade “A” milk and milk products including eggnog, yogurt, ice cream, frozen yogurt, sherbet, ice cream bars, milkshakes, processed cheese slices and spreads, cream cheese, cottage cheese, and ricotta cheese 
  • Dry, refrigerated, or frozen pasteurized whipped topping
  • Commercially packaged hard and semi-soft cheeses such as cheddar, mozzarella, parmesan, Swiss, Monterey Jack, etc.
  • Cooked soft cheeses such as Brie, Camembert, feta, and farmer’s cheese. Though not completely risk-free, the risk of contracting food borne illness from COOKED soft cheeses is low.
  • Commercially sterile ready-to-feed and liquid-concentrate infant formulas (avoid powdered infant formulas if a ready-to-feed or liquid concentrate alternative is available)

NOT Safe-to-Eat Dairy

Avoid these dairy products:

  • Non-pasteurized or raw milk and milk products made from non-pasteurized or raw milk
  • Cheeses from delicatessens 
  • Cheese containing chili peppers or other uncooked vegetables
  • Cheeses with molds (such as blue, Stilton, Roquefort, gorgonzola)
  • Mexican-style soft cheese such as queso fresco and queso blanco. (They are frequently made from unpasteurized milk and are associated with a higher rate of foodborne illness.)

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Safe-to-Eat Meat and Meat Substitutes

These meat products are safe to eat:

  • All meats cooked to well done. Use a food thermometer to be sure.
    • Red meat and ground beef: minimum internal temperature of 160° F
    • Ground poultry: internal temperature of 165° F
    • Whole poultry: internal temperature of 180° F
    • Casseroles: internal temperature of 165° F 
  • Canned meats (beef, pork, lamb, poultry, fish, shellfish, game, ham, bacon, sausage, hot dogs) 
  • Eggs cooked until both white and yolk are firm 
  • Pasteurized eggs and egg substitutes (such as Egg Beaters), and powdered egg white (all can be used uncooked)
  • Commercially-packaged salami, bologna, hot dogs, ham and other luncheon meats, heated until steaming
  • Canned and shelf-stable smoked fish (refrigerate after opening). Shelf-stable refers to unopened canned, bottled, or packaged food products that can be stored at room temperature before opening; container may require refrigeration after opening.
  • Pasteurized or cooked tofu. Aseptically packaged, shelf-stable tofu and pasteurized tofu do not need to be boiled. Cut unpasteurized tofu into 1-inch cubes or smaller, and boil a minimum of five minutes in water or broth before eating or using in recipes.
  • Refrigerated smoked seafood such as salmon or trout if cooked to 160°F or contained in a cooked dish or casserole

NOT Safe-to-Eat Meat and Meat Substitutes

These meat products should be avoided:

  • Raw or undercooked meat, poultry, fish, game, tofu
  • Raw or undercooked eggs and non-pasteurized egg substitutes; no eggs over easy, soft-boiled eggs, or poached eggs 
  • Meats and cold cuts from delicatessens
  • Hard cured salami in natural wrap 
  • Uncooked refrigerated smoked seafood such as salmon or trout labeled as “nova-style,” “lox,” “kippered,” “smoked,” or “jerky”
  • Pickled fish
  • Tempe/tempeh products

Safe-to-Eat Entrees and Soups

It is safe to eat all cooked entrees and soups.

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Safe-to-Eat Fruits and Nuts

These fruit and nuts are safe to eat:

  • Well washed raw and frozen fruit; foods containing well washed raw fruits. Rinse under clean, running water before use, including produce that is to be cooked or peeled (such as bananas, oranges and melon).
  • Cooked, canned, and frozen fruit
  • Pasteurized juices and frozen juice concentrates 
  • Dried fruits
  • Canned or bottled roasted nuts
  • Shelled, roasted nuts, and nuts in baked products
  • Commercially packaged nut butters (such as peanut butter, almond butter, soybean butter)

NOT Safe-to-Eat Fruits and Nuts

The following preparations of fruits and nuts should be avoided:

  • Unwashed raw fruits 
  • Unroasted raw nuts
  • Roasted nuts in the shell 
  • Non-pasteurized fruit and vegetable juices
  • Fresh fruit salsa found in the grocery refrigerator case 
  • Non-pasteurized items containing raw fruits found in the grocery refrigerator case

Safe-to-Eat Vegetables

The following vegetables are safe to eat:

  • Well washed raw and frozen vegetables. Rinse under clean, running water before use, including produce that is to be cooked or peeled (such as squash).
  • Fresh, well washed  herbs and dried herbs and spices (added to raw or cooked foods)
  • All cooked fresh, frozen or canned vegetables, including potatoes
  • Shelf-stable bottled salsa (refrigerate after opening). Shelf-stable refers to food products that can be stored at room temperature before opening.
  •  Cooked vegetable sprouts (such as mung bean sprouts) 

NOT Safe-to-Eat Vegetables

These vegetables should be avoided:

  • Unwashed raw vegetables or herbs
  • Fresh, non-pasteurized vegetable salsa found in the grocery refrigerator case
  • Non-pasteurized items containing raw vegetables found in the grocery refrigerator case
  • All raw vegetable sprouts (alfalfa sprouts, clover sprouts, mung bean sprouts, all others)
  • Salads from delicatessens

Safe-to-Eat Bread, Grain, and Cereal Products

These bread products are safe to eat:

  • All breads, bagels, rolls, English muffins, muffins, pancakes, sweet rolls, waffles, French toast
  • Potato chips, corn chips, tortilla chips, pretzels, popcorn
  • Cooked grains and grain products, including pasta and rice
  • All cereals, cooked and ready-to-eat

NOT Safe-to-Eat Bread, Grain, and Cereal Products

These products should be avoided:

  • Raw (not baked or cooked) grain products (such as raw oats)

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Safe-to-Eat Beverages

See our water safety guidelines for instructions on safe sources of tap water and bottled water and water preparation instructions. These beverages are safe:

  • Boiled well water
  • Tap water and ice made from tap water from a city water supply or municipal well serving highly populated areas
  • Commercially-bottled distilled, spring, and natural waters
  • All canned, bottled and powdered beverages
  • Instant and brewed coffee and tea made with boiling water
  • Herbal teas brewed from commercially packaged tea bags
  • Commercial nutritional supplements, both liquid and powdered 
  • Commercially sterile ready-to-feed and liquid-concentrate infant formulas (avoid powdered infant formulas if a ready-to-feed or liquid concentrate alternative is available)

NOT Safe-to-Eat Beverages

These beverages should be avoided:

  • Unboiled well water
  • Cold-brewed tea (‘sun tea’) made with warm or cold water
  • Non-pasteurized fruit or vegetable juice
  • Mate´ tea
  • Wine
  • Unpasteurized beer

(Note: All alcoholic beverages should only be consumed following physician approval.)

Safe-to-Eat Desserts

These desserts are safe to eat:

  • Refrigerated commercial and homemade cakes, pies, pastries and pudding
  • Refrigerated cream-filled pastries
  • Cookies, both homemade and commercially prepared
  • Shelf-stable cream-filled cupcakes (such as Twinkies, Ding Dongs) and fruit pies (such as Poptarts and Hostess fruit pies) 
  • Canned and refrigerated pudding
  • Ices, popsicles, and similar products
  • Candy, gum

NOT Safe-to-Eat Desserts

These desserts should be avoided:

  • Unrefrigerated cream-filled pastry products (not shelf-stable). Shelf-stable refers to packaged food products that can be stored at room temperature before opening; container may require refrigeration after opening.
  • Raw honey; honey in the comb
  • Honey products are not allowed for any child younger than one year of age and not allowed for children with SCIDS until nine months post transplant.

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Safe-to-Eat Fats

The following fats are safe to eat:

  • Vegetable oils and shortening
  • Refrigerated lard, margarine, and butter
  • Commercial, shelf-stable mayonnaise and salad dressings including Blue Cheese and other cheese-based salad dressings (refrigerate after opening). Shelf-stable refers to food products that can be stored at room temperature before opening. 
  • Cooked gravy and sauces

Not-Safe-to-Eat Fats

The following fats should be avoided:

  • Fresh salad dressings (stored in the grocer’s refrigerated case) containing raw eggs or cheeses listed as “Do Not Eat” under “Dairy.”

Other Safe-to-Eat Foods

These foods are safe to eat:

  • Commercial pasteurized Grade A honey. Honey products are not allowed for any child less than one year of age and not allowed for children with SCIDS until nine months post transplant.
  • Salt, granulated sugar, brown sugar
  • Jam, jelly, syrups (refrigerate after opening)
  • Catsup, mustard, BBQ sauce, soy sauce, other condiments (refrigerate after opening) 
  • Pickles, pickle relish, olives (refrigerate after opening)
  • Vinegar

Not-Safe-to-Eat Foods

These foods should be avoided: