Psychosocial assessment and follow-up in vascularized composite allotransplantation candidates: clinical observations from the Finnish experience

Psychosocial assessment is increasingly recognized as a central component in the evaluation of candidates for vascularized composite allotransplantation (VCA), yet published clinical perspectives remain limited. Drawing on longitudinal clinical observations of five candidates assessed for VCA, three of whom subsequently underwent transplantation in the Finnish VCA program at Helsinki University Hospital, this article reflects on key considerations shaping psychosocial assessment and follow-up. Psychosocial assessment in VCA requires longitudinal, multidisciplinary information gathering, with the clinical picture evolving across successive encounters. Three interrelated domains appear particularly relevant to clinical assessment: psychosocial functioning, cognitive capacity, and social context. We further propose that the concept of mentalization may offer a useful lens for understanding individuals’ abilities to reflect on their illness, expectations, interpersonal relationships, and possible changes following transplantation.