| | Comorbidity | Procedure | Associated risk |
| | Cardiovascular | ECG, heart ultrasound with Doppler ergometry or pharmacological stress test (>50 years or with multiple cardiovascular risk factors for coronary heart disease), coronary angiography (with positive ergometry test or pharmacological stress test) | In the case of adequately treated coronary heart disease, the risk is equal to the rest of the population, for recipients aged >70 years increased cardiovascular risk | | Respiratory | Chest X-ray, spirometry, diffusion capacity for CO, the definition of hepatopulmonary syndrome (HPS; calculation of alveolar/arterial oxygen gradient or contrast echocardiography) and portopulmonary hypertension (PPHTN; mean pulmonary artery pressure—MPAP >30 mmHg, right-sided cardiac catheterization is obligatory) | For HPS and pO2 <50 mmHg without response to 100% oxygen therapy—possible irreversible respiratory failure not corrected with LT, for PPHTN and MPAP ≥35 mmHg not responding to pulmonary vasodilator therapy—high perioperative mortality
MPAP 35–50 mmHg—50% risk of mortality after LT [59]
MAP >50 mmHg absolute contraindication for LT—100% risk of posttransplantation mortality [59] | | Renal | Abdominal and kidney ultrasound, spot urine test, K/Na/protein/creatinine in daily urine, eGFR (MDRD6) | Sevenfold increased perioperative risk recipients with GFR <30 mL/min or hepatorenal syndrome and dialysis >8–12 weeks or >30% glomerulosclerosis or fibrosis on kidney biopsy—simultaneous liver and kidney transplantation indicated | | Nutritive status | Body mass index (BMI), prealbumin, psoas thickness (MSCT) | Recipients with a BMI <18.5 or >40 have elevated mortality | | Osteoporosis | Densitometry | Osteoporotic fracture (fractures of the hip, vertebrae, and distal forearm are the most common) | | Infections | The first level of screening consists of screening for human immunodeficiency virus (HIV) 1 and 2 antibodies, HBV serology,
HCV antibodies, HAV antibodies, cytomegalovirus (CMV), and completing a chest X-ray [51]
The second level of screening consists of screening for Mycobacterium tuberculosis (history + PPD-Mantoux + IFN gamma
release assays), Epstein–Barr virus (EBV), human herpes virus 8 (HHV-8), varicella-zoster virus (VZV), herpes simplex virus
1 (HSV-1), herpes simplex virus 2 (HSV-2), urine culture, parasitological examination and stool culture (Strongyloides stercoralis serology, Toxoplasma gondii IgG, Treponema pallidum serology), Immunoenzymatic Assay with Venereal Disease Research Laboratory (VDRL), Staphylococcus aureus nasal/axillary swab, and dentist review recipients should receive the vaccine for HAV, HBV, chickenpox, pneumococcus, influenza, tetanus, COVID-19 | Uncontrolled sepsis, bacterial, viral, and invasive fungal infections (aspergillosis) are a contraindication for the LT procedure |
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