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Summary The increasing global prevalence of SARS‐CoV‐2 and the resulting COVID‐19 disease pandemic pose significant concerns for clinical management of solid organ transplant recipients (SOTR). Wearable devices that can measure physiologic changes in biometrics including heart rate, heart rate variability, body temperature, respiratory, activity (such as steps taken per day) and sleep patterns, and blood oxygen saturation show utility for the early detection of infection before clinical presentation of symptoms. Recent algorithms developed using preliminary wearable datasets show that SARS‐CoV‐2 is detectable before clinical symptoms in >80% of adults. Early detection of SARS‐CoV‐2, influenza, and other pathogens in SOTR, and their household members, could facilitate early interventions such as self‐isolation and early clinical management of relevant infection(s). Ongoing studies testing the utility of wearable devices such as smartwatches for early detection of SARS‐CoV‐2 and other infections in the general population are reviewed here, along with the practical challenges to implementing these processes at scale in pediatric and adult SOTR, and their household members. The resources and logistics, including transplant‐specific analyses pipelines to account for confounders such as polypharmacy and comorbidities, required in studies of pediatric and adult SOTR for the robust early detection of SARS‐CoV‐2, and other infections are also reviewed.

INTRODUCTION: Transplant volume represents lung transplant (LTx) expertise and predicts outcomes, so we sought to determine outcomes related to center volumes in CF. METHODS: United Network for Organ Sharing data were queried for CF patients receiving bilateral LTx from 2005-2015. Multivariable Cox regression was used to model survival to 1 year and long-term (>1 year) survival, conditional on surviving at least 1 year. RESULTS: 2,025 patients and 67 centers were included in the analysis. The median annual LTx volumes were 3 in CF (interquartile range [IQR]: 2, 6), and 17 in non-CF (IQR: 8, 33). Multivariable Cox regression in cases with complete data and surviving at least 1 year (n=1,510) demonstrated that greater annual CF LTx volume (HR per 10 LTx=0.66; 95% CI: 0.49, 0.89; p=0.006) but not greater non-CF LTx volume (HR=1.00; 95% CI: 0.96, 1.05; p=0.844) was associated with improved long-term survival in LTx recipients with CF. A Wald interaction test confirmed that CF LTx volume was more strongly associated with long-term outcomes than non-CF LTx volume (p=0.012). Center volume was not associated with 1-year survival. CONCLUSIONS: CF-specific expertise predicted improved long-term outcomes of LTx for CF, whereas general LTx expertise was unassociated with CF patients' survival. This article is protected by copyright. All rights reserved.