Psychological factors and immune–inflammatory mechanisms in cancer-related organ transplantation: Toward a multimodal integrative framework

Cancer patients who undergo organ transplantation after oncologic treatment experience complex biological and psychological stressors that jointly influence immune recovery and graft function. Psychological distress—particularly anxiety and depression—activates neuroendocrine and autonomic pathways that modulate cytokine release, inflammation, and immune tolerance. Evidence from psycho-oncology and transplantation studies demonstrates that heightened distress and low resilience correlate with increased interleukin-6, tumour necrosis factor-α, and C-reactive protein levels, impaired cellular immunity, and delayed post-operative recovery. This review integrates current findings from psychoneuroimmunology, transplantation medicine, and behavioural oncology to elucidate how donor characteristics, perfusion parameters, and psychosocial factors interact to shape outcomes in cancer-related transplantation. Routine psychological assessment using validated instruments such as the Hospital Anxiety and Depression Scale (HADS), together with early interventions—cognitive-behavioural therapy, mindfulness-based stress reduction, and resilience training—may reduce inflammatory activity and improve recovery trajectories. Furthermore, emerging multimodal and machine-learning-assisted analytic approaches provide opportunities for personalised psychosocial care and risk stratification. Understanding these psych neuroimmune interactions supports the development of integrative, precision-based rehabilitation strategies within the scope of psycho-oncology.