*Purpose: Exercise training has been shown to be beneficial across several chronic disease groups that may lead to solid organ transplantation (SOT), and across organ groups post-transplant. There are currently no practice guidelines for exercise training before and after SOT which can limit the uptake of the research evidence into clinical practice. The objectives of this position statement were to provide evidence-based and expert-informed recommendations for exercise training pre- and post-transplant in adult and paediatric SOT population, and on the outcomes relevant to exercise training and physical function that should be evaluated in SOT.

*Methods: The search strategy was designed to identify randomized controlled trials (RCTs) and/or systematic reviews of exercise interventions in SOT (lung, heart, kidney, liver, and pancreas) candidates and recipients but when not available, all relevant study designs were reviewed. The key messages were based on scientific evidence and expert-informed opinion and were agreed upon by consensus of the working group. The GRADE (Grading of Recommendations Assessment, Development and Evaluation) was used to evaluate the evidence for exercise in adult SOT recipients.

*Results: Pre-transplant studies utilized a variety of study designs in populations of SOT candidates and/or people with end-stage chronic disease. Findings suggest that exercise training pre-transplant was safe but there was insufficient evidence to provide guidelines on the training parameters or length of exercise program to obtain benefits in the pre-transplant phase. In SOT recipients, RCTs demonstrated that exercise training improved exercise capacity, lower extremity muscle strength and health-related quality of life. To obtain benefits early or late post-transplant, exercise training should be of moderate to vigorous-intensity level, three to five times a week for a minimum of 8 weeks. In pediatrics, due to the lack of evidence, specific recommendations regarding the type, training parameters or length of exercise program could not be provided.

*Conclusions: Exercise training should be offered in the pre- and post-transplant phase in all organ groups for both adults and children. There is insufficient evidence to provide guidance on the specific training parameters and duration in adult transplant candidates and pediatric transplant candidates and recipients.

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