A systematic review of the effectiveness of psychological interventions in organ transplantation

Concetta De Pasquale¹Maria Luisa Pistorio^1*Alberto Sardella²Massimiliano Veroux¹Vittorio Lenzo¹Micol Di Bella¹Flavia Coco¹Giuseppa Maria Stella Catania¹Antonino Grasso¹Alessia Giaquinta¹Maria C. Quattropani¹Pierfrancesco Veroux¹

• ¹University of Catania, Catania, Italy
• ²Universita degli Studi di Catania, Catania, Italy

Background: Organ transplantation profoundly affects not only patients' physical health but also their psychological, emotional, and social well-being. Psychological interventions may support treatment adherence, emotional adjustment, and quality of life, yet the existing literature remains fragmented and methodologically heterogeneous. Objectives: This systematic review aimed to examine the available evidence on the effectiveness of psychological interventions in solid organ transplant recipients, with particular attention to outcomes related to anxiety, depression, stress, adherence, and quality of life Methods: Following the PRISMA 2020 guidelines and with the protocol registered on PROSPERO (ID 1165280), a comprehensive search was conducted across PubMed, Scopus, and Web of Science. Inclusion criteria targeted studies involving adult solid organ transplant recipients receiving validated psychological or psychosocial interventions. Twenty-four studies met the eligibility criteria. Data extraction included demographic characteristics, organ type, psychological outcomes, intervention type, and duration. Relevant data, including quantitative findings and effect sizes where available, were extracted and synthesized. Results: The included studies revealed a heterogeneous yet coherent body of evidence supporting the relevance of psychological interventions in transplant care. Various approaches—including cognitive-behavioral, psychoeducational, mindfulness-based, expressive, and psychodynamic interventions—were associated, to different extents, with improvements in emotional well-being, adherence, and quality of life. The diversity of designs and outcomes, however, limits direct comparisons and precludes firm conclusions about relative effectiveness. Conclusions: Psychological interventions represent a key component of comprehensive transplant care, contributing to patients' emotional adjustment, adherence, and overall quality of life. Nonetheless, current evidence is constrained by small sample sizes, methodological heterogeneity, and short follow-ups. Future research should prioritize multicentre and longitudinal studies using standardized psychological and clinical outcomes, in order to strengthen the current evidence base and support the systematic integration of psychological interventions into transplant care.