A nurse assesses a client who is a possible candidate for a liver transplant for contraindications of a liver transplant. Which findings should the nurse report to the provider? Select all that apply.

Rationale: A. Severe pulmonary disease is a relative or absolute contraindication for liver transplantation. End-stage COPD increases perioperative risk and postoperative complications due to impaired oxygenation and poor ventilatory reserve. This finding should be reported to the provider. B. Significant cardiovascular disease, such as severe heart failure or coronary artery disease, increases surgical risk and can be a contraindication to liver transplant. Cardiac status must be stable to tolerate surgery and immunosuppressive therapy. C. Post-transplant patients require strict adherence to complex medication regimens, especially immunosuppressants, to prevent graft rejection. A client who cannot reliably follow instructions or manage medications is at high risk for complications, making this a contraindication. D. Hepatitis C infection is not a contraindication to liver transplantation. In fact, liver transplants are commonly performed for end-stage liver disease secondary to hepatitis C. Antiviral therapy may be used post-transplant. E. Active malignancy outside the liver (metastatic cancer) is an absolute contraindication because immunosuppression required after transplantation can accelerate tumor growth and metastasis, leading to poor outcomes.