A nurse is reinforcing teaching about renal transplant with a newly licensed nurse. Which of the following clients should the nurse identify as having a contraindication for this procedure?

A. A BMI of 25 is classified as overweight but not severely obese, and is generally not a contraindication for renal transplantation. Excessive obesity (BMI ≥35–40) may increase surgical risk, but a BMI of 25 is considered acceptable. B. Having a pacemaker is not an absolute contraindication to kidney transplantation. Preoperative planning and monitoring can safely accommodate clients with pacemakers during surgery. C. Age alone is not a contraindication to renal transplantation. While older age may increase perioperative risk, candidates are assessed based on overall health, comorbidities, and functional status, not chronological age. D. Active or recent intravenous drug use is considered a contraindication for kidney transplantation because it increases the risk of infection, poor adherence to immunosuppressive therapy, and graft loss. Most transplant programs require a period of abstinence and demonstrated compliance before considering these clients as eligible candidates.