Nutrition management of the postoperative lung transplant recipient

Management of the post-lung transplant recipient can be difficult because of the heterogeneity of recipients, intraoperative surgical challenges, and postoperative complications. Up to 55% of lung transplant recipients are malnourished or at risk for malnutrition going into surgery, which is likely to worsen postoperatively. Nutrition support is often inhibited by hemodynamic variability, laboratory abnormalities, and gastrointestinal complications. While these findings are uncommon in other solid organ transplants, lung transplant recipients may experience gastroparesis, esophageal dysfunction, and severe gastroesophageal reflux, among other conditions, that affect the ability to provide adequate nutrition in a timely manner. The lung transplant dietitian must be able to understand and recognize these potential risks and modify the nutrition care plan as appropriate. This review will focus on best practice recommendations to navigate these challenges and optimize nutrition status during hospitalization after lung transplantation.