Implementing remote patient monitoring in lung transplant care: A real-world evaluation

Background: Lung transplant recipients require close post-transplant surveillance, which imposes substantial travel and resource burdens. Remote patient monitoring (RPM), which uses home-based transmission of patient symptoms and physiologic data, has demonstrated benefit in other populations; however, data in lung transplantation remains limited. Methods: We conducted a single-center observational study of lung transplant recipients enrolled in a 12-month RPM program at Mayo Clinic Rochester. Patients used home devices to transmit symptoms, vital signs, and spirometry. Prespecified abnormal values generated alerts that were reviewed and escalated as appropriate. Primary outcomes included adherence, early discontinuation, and the impact of escalations on management. Results: One hundred and sixteen patients were enrolled. By December 2025, 47 (40.5%) completed the program, 15 (12.9%) discontinued participation, and 54 (46.6%) remained monitored. The median distance from the transplant center was 234 miles (IQR 99-385). Four hundred and seventy escalation alerts were generated, most commonly due to declines in FEV₁ (58.3%). Most escalations (72.8%) were managed with continued monitoring, while 27.2% prompted changes in care, including expedited clinic visits, diagnostic testing, medication adjustments, or emergency evaluation. Among 64 admissions with transmitted data, 31 (48.4%) were preceded by an RPM escalation in the prior 7 days. Conclusions: RPM is feasible and acceptable for post-transplant surveillance and can identify meaningful changes in health status and may be particularly useful with geographically dispersed patients. Nearly half of admissions with transmitted data were preceded by an escalation, but a substantial proportion were not, highlighting opportunities to optimize adherence and alerting thresholds.