Diet Guidelines for Transplant Patients
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, tacrolimus, sirolimus, or MMF. This may be about one year, but your medical team and dietitian will determine the appropriate length of time.
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.
- Meat and Meat Substitutes
- Fruits and Nuts
- Bread, Grain, and Cereal Products
- Other Foods
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 .
- Refrigerated or frozen pasteurized whipped topping/whipped cream.
- 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.
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 and delis.
- Cheese containing chili peppers or other uncooked vegetables (like pepperjack.)
- 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.)
These meat products are safe to eat:
- Cook all meats to well done and 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
- For hot dogs, “ready-to-eat” sliced lunch meats, cold cuts, and summer sausage, heat in the microwave or oven until steaming before eating.
- Canned meats (beef, pork, lamb, poultry, fish, shellfish, game, ham, bacon, sausage, hot dogs)
- Cook eggs until both the white and yolk are firm, not runny.
- Pasteurized eggs and egg substitutes (such as Egg Beaters®), and powdered egg white (all can be used uncooked)
- Canned and shelf-stable smoked fish are acceptable, (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
Unsafe Meat and Meat Substitutes
Avoid these meat products:
- Raw or undercooked meat, poultry, fish, game, tofu; there should be no pink or red in the flesh or juices of the meat.
- 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
It is safe to eat all cooked entrees and soups.
Soups and sauces should be brought to a boil when reheating.
These fruit and vegetables are safe to eat:
- Well washed raw fruits and vegetables; foods containing well washed raw fruits. Rinse all produce, whether raw or frozen, under clean running water before use. This includes produce that will be cooked or peeled (such as bananas, oranges, and melon).
- Cooked, canned, and frozen fruits and vegetables.
- Pasteurized juices and frozen juice concentrates
- Dried fruits
Unsafe Fruits and Vegetables
Avoid the following preparations of fruits and vegetables:
- Unwashed raw or frozen fruits, vegetables, or herbs
- Non-pasteurized fruit and vegetable juices
- Fresh salsa found in the grocery refrigerator case or restaurant
- Non-pasteurized items containing raw fruits or vegtables found in the grocery refrigerator case
Safe-to-Eat Nuts and Seeds
- 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)
Unsafe Nuts and Seeds
- Raw, unshelled nuts, and seeds
- Nut butters from the self-service machine
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
Unsafe Bread, Grain, and Cereal Products
These products should be avoided:
- Raw (not baked or cooked) grain products (such as raw oats)
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®) and fruit pies (such as Poptarts® and Hostess® products)
- Canned and refrigerated pudding
- Popsicles and similar products
- Candy, gum
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.
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
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.”
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)
- Shelf-stable pickles, pickle relish, olives (refrigerate after opening)
These foods should be avoided:
- Raw honey; honey in the comb
- Herbal and nutrient supplement preparations. See Guidelines for Herbal and Nutrient Supplements.
- Brewer’s yeast, if uncooked
- Olives from the self-serve bar
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 stored in the refrigerator up to 48 hours
- 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
- Tea made with boiling water
- Herbal teas brewed from commercially packaged tea bags
- Commercial nutritional supplements, both liquid and powdered
Unsafe to Drink 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
- Unpasteurized beer
(Note: All alcoholic beverages should only be consumed following physician approval.)