Usually, an organ transplant leads to a clear improvement of the physical as well as the mental quality of life. But sometimes, in spite of medical success, patients turn away from the treatment and give up the self-care that is essential for survival (e.g., by not taking their medication regularly or not taking it at all). This article looks at this lack of self-care in the context of self-destructive tendencies, as well as in the context of a conflict between life and death drive, as Freud has described. Infantile as well as present frustrations may contribute to the patient's libidinous withdrawal or disobjectalization. At the end of the article, the relevance of an early detection of this withdrawal is emphasized, and the possibilities and limitations of psychoanalytical interventions are discussed.