Actionable events in preimmunosuppression comorbidity screening
| Situation | Recommendation |
| Suspicion of parenchymal lung disease | Smoking cessation advice Lung function tests X-ray of the chest±high-resolution CT scan of the chest Consider referral to a respiratory physician |
| HIV, HBV and HCV | Consider antiviral treatment prior to immunosuppression (discuss with specialist) |
| Abnormal liver biochemistry (AST or ALT>100 IU/L) | Not an absolute contraindication Select less hepatotoxic drug: MMF instead of AZA |
| Abnormal synthetic liver function | Not an absolute contraindication Increased risk of toxicity, except MMF |
| Chronic renal impairment (CRI) | Investigate cause for newly identified CRI Alter dose/frequency and monitoring (table 14) |
| Cardiovascular risk | Primary prevention pretreatment |
| Previous malignancy | Not an absolute contraindication Routine population screening recommended |
ALT, alanine transaminase; AST, aspartate aminotransferase; AZA, azathioprine; HBV, hepatitis B virus; HCV, hepatitis C virus; MMF, mycophenolate mofetil; MTX, methotrexate.