Living Beyond the Transplant: A Systematic Qualitative Review of Psychological Adaptation in Adult Organ Recipients

Solid organ transplantation represents not only a physiological intervention but also a profound psychological transition. While the biomedical outcomes of transplantation are well-documented, less attention has been paid to recipients’ emotional adjustment. This systematic review aimed to synthesise qualitative evidence on the psychological adaptation of adult transplant recipients, focusing on the emotional stressors they face, the coping strategies they employ, and the contextual factors that influence their post-transplant adjustment. Searches were conducted across five databases for peer-reviewed qualitative studies published in English between 2005 and 2025. Studies were included if they focused on psychological adaptation following solid organ transplantation in adult recipients. Six qualitative studies were thematically synthesised. Five themes were identified, reflecting persistent uncertainty, identity renegotiation, relational adaptation, coping strategies, and systemic influences. Psychological adaptation emerged as a prolonged and non-linear process shaped by social support, cultural beliefs, and access to appropriate care. Psychological recovery after transplantation extends far beyond surgical success, requiring sustained emotional adjustment shaped by personal, relational, and systemic influences. Findings highlight the need for transplant care models that prioritise culturally sensitive, relational, and longitudinal psychological support. Future research should explore how adaptive processes evolve over time and how co-produced psychosocial interventions might enhance recipient wellbeing.