Implementation of Spirometry Telemonitoring Programme in Lung Transplant Recipients: A Retrospective, Controlled Analysis of Clinical Outcomes

Background: Lung transplantation (LTx) is the final therapeutic option for patients with end-stage irreversible respiratory failure. Chronic lung allograft dysfunction (CLAD) remains a major determinant of long-term outcomes, but early detection of functional decline may enable timely intervention and partial reversibility. Therefore, systematic monitoring of graft function is essential, and telemedicine-based spirometry may facilitate early identification of clinically relevant decreases in lung function. Objective: The aim of our study was to evaluate the feasibility of spirometry telemonitoring (TM) and its association with healthcare utilisation in lung transplant patients. Methods: This retrospective study compared lung transplant recipients: the first group underwent spirometry TM (n = 21), the second group was monitored with standard home spirometry (HS) (n = 23), and the control group underwent routine follow-ups only at the transplant centre (n = 32). Results: In the TM spirometry group, mean adherence was 62.7%, with 4957 examinations performed over a mean monitoring period of 252 days; 59.7% of FEV1 and 58.9% of FVC measurements were technically acceptable. Compared with routine care (RC), TM spirometry was associated with a shorter mean duration of both combined planned and urgent admissions (5.8 vs. 10.0 days, p < 0.001) and urgent admissions analysed separately (14.7 vs. 26.2 days, p < 0.001). Conclusions: TM spirometry was feasible and associated with lower healthcare utilisation in lung transplant recipients, supporting its potential value for post-transplant surveillance. Larger prospective randomised studies are needed to confirm these preliminary findings.