Transplant dietitians
Members of the team at UHN's Ajmera Transplant Centre who work with patients on their nutrition needs include (L to R): Faye Wu, diet technician, Anna Richardson, kidney transplant and hemodialysis dietitian, Julie Statler, inpatient multi-organ transplant dietitian, and Elizabeth McLeod, outpatient multi-organ transplant dietitian. (Photo: Courtesy Elizabeth McLeod)

Lung transplant patients often recall the journey as a roller-coaster of emotions. There are months of anticipation and hard work leading up to the big day; disappointment when calls for transplant end without surgery due to unsuitable organs; and, finally, relief when transplant occurs successfully.

Patients require lung transplant for a variety of reasons. Illnesses ranging from chronic obstructive pulmonary disease to idiopathic pulmonary fibrosis to cystic fibrosis are among common causes.

However, getting on the lung transplant waiting list has its own set of challenges. One of these, sometimes the most difficult for patients to achieve, is maintaining a healthy weight.

For lung transplant listing, patients are required to be within a specific body mass index (BMI), category, which is a measure of body fat based on weight and height. The requirement is based on years of research indicating patients and their new lungs fare better during, immediately after and in the long-term following lung transplant surgery if they have a BMI within the healthy range.

Patients are also safer during surgery and recover more quickly, allowing them to get back to the comfort of their own home in fewer days than those above or below this BMI cut-off. Despite its importance, weight management continues to be a challenge for patients coming to the program.

A range of health professionals from across disciplines are available to help patients at UHN in the pre-transplant period. These include physiotherapists to help maintain exercise capabilities, social workers to manage social supports and finances, and physicians to oversee the whole patient.

"Dietitians can offer patients a wealth of knowledge in the area of nutrition," says Elizabeth McLeod, a registered dietitian (RD) with UHN's Ajmera Transplant Centre. "We work with patients to create a nutrition plan that is safe, healthy, individualized, and will help them meet their nutrition and weight goals."

UHN has about 80 registered dietitians across many programs

March is Nutrition Month in Canada. This year's theme, selected by the Dietitians of Canada, is "Unlock the Potential of Food: Ingredients for a Healthier Tomorrow."

It's a time to celebrate the variety in food choices within various cultures, while increasing awareness of the challenges faced by many. Food justice, food sovereignty and food policy are just a few of the key topics this year's Nutrition Month is focusing on.

At UHN, there are about 80 RDs across programs including Transplant, General Medicine, Critical Care, Eating Disorders and many others. They understand the importance of making individualized recommendations tailored to the specific needs of patients, including income level, cultural background and psycho-social requirements.

"Nutrition goals vary depending on program and individual needs and dietitians are able to take all these factors and synthesize them into a cohesive plan," Elizabeth says. "One thing all programs have in common is the overall emphasis on the general health and well-being of patients.

"Nutrition Month is the perfect time to appreciate the work all dietitians do for each and every patient across UHN."

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