Evaluation of patients for organ transplantation requires examination of both medical and psychosocial factors. The most common psychiatric disorders encountered in the pre-transplant population are depression, anxiety, adjustment disorders, and substance use disorders. Once detected, these disorders can be treated with psychotherapy and medications. Patients who have just received transplants often develop post-operative delirium. Typical causes, such as hypoxia, metabolic disturbance, and polypharmacy, are the most common. In patients who have already been transplanted, depression and anxiety disorders remain the most common diagnoses. A number of patients suffer setbacks or complications after transplant and fail to make a full recovery; a smaller number die soon after transplant. Assisting patients with the realities of life after transplant, particularly those patients who make less than a full recovery, is just as important as providing support before transplant.