Food Safety Recommendations for Transplant Recipients

These instructions are for Children's Hospital of Philadelphia (CHOP) patients who receive a solid organ or bone marrow transplant.

Important information:

• Food safety is an important part of post-transplant care. As a transplant recipient, you may be prescribed immunosuppressive medications to prevent rejection of your new transplanted organ or bone marrow. These medications can put you at risk for developing infections, including foodborne illnesses.

• Symptoms of a foodborne illness include nausea, vomiting, diarrhea, and fever. To reduce the risk of foodborne illness, follow the recommendations below.

Instructions to lower the risk of foodborne illness:

Choose lower-risk foods:

Some foods may have a higher risk of containing foodborne bacteria or pathogens. Choose the lower-risk options most often. If you are unsure about the safety of a food choice, make another choice.

• Meat and poultry:

  • Choose well-cooked meat and poultry.

  • Avoid raw or undercooked meat or poultry.

• Seafood:

  • Choose cooked fish and seafood.

  • Avoid raw or partially cooked fish and seafood, like sushi.

• Milk:

  • Choose pasteurized milk.

  • Avoid unpasteurized (raw) milk.

• Eggs:

  • Choose fully cooked eggs. If making undercooked eggs, use pasteurized eggs.

  • Avoid foods that contain raw egg such as raw cookie dough and homemade eggnog.

• Fruits & Vegetables:

  • Choose cooked fruits and vegetables, washed fresh fruits and vegetables, including salads.

  • Avoid unwashed fruits and vegetables, including lettuce and leafy greens.

• Cheese:

  • Choose hard and soft cheeses made from pasteurized milk, processed cheese, cream cheese.

  • Avoid soft cheese made from unpasteurized (raw) milk.

• Other:

  • Choose heated hot dogs and deli meat and shelf stable meat spreads.

  • Avoid unheated hot dogs and deli meat, fresh meat spreads that are not pasteurized

Tips for preparing foods:

• Clean hands and equipment often.

• Rinse fresh fruits and vegetables well.

• Separate ingredients such as raw meat, seafood, and eggs from ready-to-eat foods.

• Thaw foods in the refrigerator, under running cold water, or in the microwave. Never thaw foods on the counter.

• Chill leftovers within two hours or less after eating.

• Cook your food to safe internal temperatures (according to the USDA-FDA):

  • Beef, pork, veal, lamb, and fish: 145° Fahrenheit.

  • Ground beef, pork, veal, and lamb: 160° Fahrenheit.

  • Egg dishes: 160° Fahrenheit.

  • Poultry including turkey, chicken, and duck: 165° Fahrenheit.

• Do not store food in the refrigerator (40°) for longer than recommended:

  • Fresh eggs in shell: 3-5 weeks.

  • Liquid eggs: 3 days, once opened.

  • Hardboiled eggs: 7 days.

  • Raw sausage and ground meats, fresh poultry, and seafood: 1-2 days.

  • Bacon: 7 days.

  • Raw steaks, roasts, and chops: 3-5 days.

  • Leftovers: 3-4 days.

Tips for food shopping:

• Check the "sell by" date, choose ones with the furthest date away.

• Buy only pasteurized milk, juice, cheese, and dairy products.

• Do not buy food that is displayed in unclean environments.

• Purchase products that are free from dents, cracks, or bruises.

Tips for eating out:

• Eating out can still be enjoyed post-transplant. Choose trusted restaurants that are safe and clean looking.

• Avoid any uncooked ingredients such as raw eggs, meat, poultry, or seafood.

• To limit the spread of germs at parties with buffet style food, be the first one to get food. Avoid restaurant buffets.

• Refrigerate your leftovers within two hours after eating out.

Call your CHOP transplant team with any questions or concerns. Any specific questions regarding food choices and supplements can be answered by your primary team, clinical pharmacist, or registered dietitian.

Additional food safety information can be found at www.fsis.usda.gov/food-safety.

Reviewed on June 1, 2022, by Kelsey Palm, RD; Susan McGowan, RD