Nutrition Recalibration in Transplant Recipients: A Phase-Based Metabolic Strategy for Optimizing Graft and Patient Outcomes Authors Sourabh Sharma Department of Nephrology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India; Sabine Karam Division of Nephrology and Hypertension, University of Minnesota, Minneapolis, Minnesota, USA; Rasha Shemies Mansoura Nephrology and Dialysis Unit, Mansoura University, Mansoura, Egypt; Sanjay Kalra Department of Endocrinology, Bharti Hospital, Karnal, India; University Centre for Research & Development, Chandigarh University, Mohali, India. DOI: https://doi.org/10.47391/JPMA.26-64 Abstract 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. Keywords: Immunosuppression, Insulin resistance, Nutrition, Protein Downloads Full Text Article Published 2026-07-12 How to Cite Sourabh Sharma, Sabine Karam, Rasha Shemies, & Sanjay Kalra. (2026). Nutrition Recalibration in Transplant Recipients: A Phase-Based Metabolic Strategy for Optimizing Graft and Patient Outcomes. Journal of the Pakistan Medical Association, 76(8), 1375–1378. https://doi.org/10.47391/JPMA.26-64 More Citation Formats ACM ACS APA ABNT Chicago Harvard IEEE MLA Turabian Vancouver Download Citation Endnote/Zotero/Mendeley (RIS) BibTeX Issue Vol. 76 No. 8 (2026): AUGUST Section ADVANCES IN NEPHROLOGY License Copyright (c) 2026 Journal of the Pakistan Medical Association This work is licensed under a Creative Commons Attribution 4.0 International License.