“…Although the risk of long-term adverse effects of immunosuppression and the burden of multiple episodes of acute rejection are well documented 3,4 and have sparked ethical debate, recent studies demonstrate a shifting conversation regarding ethics in vascularized composite allotransplantation (VCA) 5 and an increasingly positive public perception surrounding the procedure. 6 Cited psychological burden by the family can be overcome by building and maintaining close relationships between providers and their patient’s psychosocial support system. Moreover, preliminary psychological outcomes assessments have demonstrated less depression, less verbal abuse, improved quality of life, improved family affective responsiveness, and better social integration in recipients, 5,7–9 which supports the importance of strong and established support systems for patients.…”