*Purpose: Psychosocial factors are important predictors of medication adherence, and subsequently graft survival, in solid organ transplantation. Early experiences suggest this may be the case in VCA as well. We assessed psychosocial factors and medication adherence in VCA recipients.

*Methods: Using validated tools, we surveyed upper-extremity transplant recipients at two centers to assess depression (Patient Health Questionnaire-9), personality (Ten-Item Personality Inventory), anxiety (Generalized Anxiety Disorder 7-item Scale), PTSD (Primary Care PTSD Screen for DSM5), and social support (Multidimensional Scale of Perceived Social Support). Medication adherence among VCA recipients at two centers was assessed by a member of the clinical research team using the recipient’s medical record.

*Results: Medication adherence was reported for 12 VCA recipients and four VCA recipients completed psychosocial assessments (Table 1). Most recipients were believed to be adherent to their immunosuppression, however three recipients were believed to be non-adherent and a member of the clinical team had discussed non-adherence at least once with five recipients (Table 1). One recipient experienced loss of their transplanted extremity, however the clinical team did not believe the recipient was non-adherent.

Results from the psychosocial assessment indicated that no recipient had PTSD and all had high levels of social support. Three participants demonstrated mild anxiety and two participants demonstrated minimal symptoms of depression (Table 1). High levels of emotional stability and extraversion were each demonstrated by three participants and high levels of openness to experiences was demonstrated by two participants. However, high levels of agreeableness and conscientiousness were each demonstrated by only one participant.

*Conclusions: While most participants in this study were reported to be adherent to their immunosuppression, the clinical team had concerns that three were non-adherent. Participants in the psychosocial assessment appeared to have good social support, however they may be at risk for depression and anxiety, which has been associated with medication non-adherence in solid organ transplantation.

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