Transplant clinicians who focus on psychosocial issues know how critical the pre-transplant psychosocial evaluation is for facilitating patients' successful negotiation of the transplantation process. This is particularly the case in liver transplantation: psychosocial factors such as substance use and dependence have often directly contributed to the need for transplantation, and substance use history is often entwined with other psychosocial liabilities such as poor mental health and weak social support. Indeed, the overall value of the psychosocial evaluation as part of the medical work-up for liver and other types of solid organ transplantation is well-recognized in clinical practice guidelines and recommendations.(1-3).