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Seventeen variables were included in the cluster analysis, encompassing key demographic factors, such as age, gender, type of organ transplanted (kidney, liver, pancreas), number of transplants, and detailed substance use patterns, both pre-transplantation (pre-tx) and post-transplantation (post-tx)

For voxel-based morphometry (VBM), the images were first segmented into gray matter, white matter and cerebrospinal fluid tissue maps with the VBM8 toolbox ( Then the gray matter maps were used to generate the study-specific template by the DARTEL algebra 60

Trauma history directly amplifies the risk of emotional and behavioral relapse, as unresolved post-traumatic stress symptoms drive negative reinforcement substance use patterns that accelerate progression from experimental use to substance use disorder