Sourabh Sharma, Sabine Karam, Rasha Shemies, Sanjay Kalra
Metabolic recovery after solid organ transplantation is dynamic. Traditional nutritional strategies often assume rapid normalization of appetite and metabolic function. However, emerging evidence suggests that transplant recipients undergo a complex metabolic transition. This transition is characterized by insulin resistance, steroid exposure, altered protein turnover, and fluctuating renal function. The concept of "Nutrition Recalibration" incorporates the need for progressive, physiology-aligned nutritional adaptation. This narrative review proposes a mechanistic and clinically actionable framework for nutrition in transplant recipients. Interactions with immunosuppressive therapy, anabolic signalling pathways, and insulin sensitivity are discussed. The Nutrition Recalibration model provides a practical roadmap for clinicians seeking precision nutrition approaches in modern transplant care.