Home oscillometry monitoring after lung transplant is feasible and reliable

<bold>Introduction:</bold> Oscillometry (<bold>Osc</bold>) has been shown to be more sensitive for detecting allograft rejection after lung transplant (<bold>LTx</bold>) than spirometry, the current gold standard. Osc is performed during normal tidal breathing and easy to complete. Its utility as a home-based monitoring tool has not been well investigated. While LTx patients are followed frequently with spirometry, daily home monitoring with Osc could provide earlier markers for graft injury. <bold>Aim:</bold> To evaluate the feasibility of home Osc and compare it to pulmonary function lab-based testing in the first 3 months after LTx. <bold>Methods:</bold> All double LTx patients are eligible if discharged from hospital within 3 months of surgery. At enrolment, a qualified personnel teaches and sends the patient home with a C-100 tremoflo, the same device used in the lab. Patients are taught to perform Osc with the lab-based protocol and quality control standards. Home testing occurs daily and lab-based, weekly. <bold>Results:</bold> 9 patients (6 men, mean age 63±11 years) have completed the study to-date. Home Osc started at 60±1 days post-LTx. 3 patients were excluded due to technical difficulty (1) and lack of paired home-lab tests within a 2-day window (2). The remaining 6 patients had 17 paired home-lab Osc tests over 3 months. Agreement between home and lab Osc was high with mean differences in R5 and X5 (resistance and reactance at 5 Hz) being 5.5±15.8% and 2.8%±17.6%, respectively. Patients were highly satisfied with Osc; all preferred it to spirometry. <bold>Conclusion:</bold> Home Osc monitoring is feasible post LTx, with measurements similar to lab-based tests. Deployment of home Osc could lead to earlier detection of graft injury and is the focus of ongoing work.