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Return to work with or after a chronic disease is not a very well understood process, influenced by a variety of personal, professional, societal and medical factors. The aim of this study is to identify predictors for return to work 12 months after a solid organ transplant, applying a bio-psycho-social model. Explorative study based on patients included in the Transplant Cohort Study, a national, prospective, multicentric cohort, who underwent a first solid organ transplant (kidney, liver, heart, lung). Bio-psychosocial factors were tested and predictors of return to work identified using logistical regression models.Among the 636 patients included in the study, 49.8% (317) were employed 12 months post transplant. The major predictor for returning to work 12 months post transplant was pre-transplant employment status (OR: 10.8). Accordingly, the population was stratified in employed and unemployed pre transplant groups. Age, self-perceived health (SPH, six months post-transplant) and the transplanted organ were significantly associated with post transplantation employment status in both groups. Additionally, return to work was influenced by education, depression (six month post-transplant) and waiting time in the employed pre transplant group and by invalidity pension in the unemployed pre transplant group.Employment rate pre transplant being highly associated with employment status post transplant, the process promoting return to work should be started well before surgery.