Physical activity and its correlates in children and adolescents post‐liver transplant

The health benefits of PA are well established for healthy and chronically ill children. This study objectively measures physical fitness and PA levels in children PLT and explores potential correlates and perceived barriers impacting their PA. A total of 23 children (16 females, mean 14.01 ± 2.49 yrs) >1 yr PLT were assessed for peak oxygen consumption (VO₂peak), muscle strength, endurance, and flexibility. MVPA and steps/day were determined with accelerometry. Additionally, SE, perceived fatigue, and barriers and benefits of PA were examined. VO₂peak (mean 33. 2 ± 7.61 mL/kg/min; 77.0 ± 15.6% predicted) and PA (average 6841 ± 2299 steps/day) were below healthy norms. MVPA (31.6 ± 16.1 min/day) was lower than national guidelines. Six participants (30%) attained criterion standards for abdominal strength and one participant (5%) for push‐ups. Fatigue and SE were lower than reported levels in healthy children. A commonly perceived barrier to PA was “I am tired.” A positive correlation was shown between SE and MVPA (r = 0.57, p = 0.007), SE and fatigue (r = 0.54, p = 0.01), and PELD score and fatigue (r = 0.66, p = 0.007). Children PLT demonstrate below normal levels of PA and aerobic capacity. SE is a modifiable correlate of their PA. Further investigation of the impact of PA correlates can guide the development of future innovative PA intervention strategies in children PLT.     

Physical activity experiences in children post–liver transplant: Developing a foundation for rehabilitation interventions

Physical Activity (PA) plays an important role in the physical and psychosocial health of children and is beneficial in the treatment and prevention of comorbidities associated with transplantation. Despite this, PA participation in pediatric liver transplant recipients remains low compared to healthy peers. This qualitative‐focused mixed‐methods study explored the PA experiences and parental perception of these experiences, including perceived facilitators and barriers to PA in children post–liver transplant. Eighteen participants (9 children [median age 10.8 years] and 9 parents) took part in semi‐structured interviews and completed the PedsQL Multidimensional Fatigue Scale and PAQ. Most children reported they were physically active (PAQ median 3.08 [IQR] 2.60‐3.51), participating in PA for its enjoyment, regardless of their level of motor proficiency. Levels of fatigue (median 65.28 [IQR] 56.25‐90.97) were higher than healthy norms and impacted PA participation in some children. Children and parents perceived PA as central to post‐transplant recovery and valued its social and mental health benefits; however, parents struggled with ongoing uncertainty and perceived physical vulnerability of their child. This study indicates the need for continuing PA support and education and provides valuable information for family‐centered interventions to increase PA and improve health outcomes in children post‐transplant.     

Small effort,high impact: Focus on physical activity improves oxygen uptake (VO2peak), quality of life,and mental health after pediatric renal transplantation

This study estimates the effects on peak oxygen uptake (VO _{2 peak}), QoL, and mental health after the introduction of an adjusted post‐transplant follow‐up program, that is, early physiotherapy and focus on the importance of physical activity. VO _{2 peak} was measured by a treadmill exercise test in 20 renal‐transplanted children on the adjusted post‐transplant follow‐up and compared with a group of 22 patients investigated in a previously, before the implementation of our new follow‐up routines. PedsQL and The Strengths and Difficulties Questionnaire (SDQ ) were used to assess QoL and mental health in 45 patients on the new as compared to 32 patients on the previous follow‐up strategy. The patients exposed to early physiotherapy and a higher focus on physical activity had significantly higher VO _{2 peak} (44.3 vs 33.5 mL kg^?1 min^?1, P  = .031) in addition to improved QoL (P  = .003) and mental health scores (P  = .012). The cardiovascular risk profile was similar in both groups aside from significantly higher triglycerides in the present cohort. Small efforts as early physiotherapy and increased focus on physical activity after pediatric renal transplantation have significant impact on cardiorespiratory fitness, QoL, and mental health. The importance of physical activity should therefore be emphasized in follow‐up programs.     

A personalized approach to exercise promotion in adolescents with type 1 diabetes

Faulkner MS, Michaliszyn SF, Hepworth JT. A personalized approach to exercise promotion in adolescents with type 1 diabetes. Purpose: This exploratory study tested the feasibility of conducting a novel, personalized exercise intervention based upon the current fitness levels of adolescents with type 1 diabetes (T1DM). The relationships of perceptions of benefits and barriers to exercise, exercise self‐efficacy and family support to exercise adherence and changes in cardiovascular (CV) fitness, quality of life (QOL), and glycemic control were studied. Methods: Adolescents who were sedentary received a graded exercise test to determine their current fitness level (VO_2peak). A 16‐wk personalized exercise program was developed for each adolescent based upon individual fitness level and exercise preferences. Pretest and posttest measures of exercise self‐efficacy, benefits and barriers to exercise, family support, and diabetes QOL were completed. A1c levels were obtained using the DCA2000^®. Adherence to exercise was measured using the Actigraph? Accelerometer. Results: Twelve adolescents completed the study. Accelerometry data revealed adherence to 60 min of moderate‐to‐vigorous physical activity (MVPA) per day for a mean of 45.5 (SD = 23.9)% of the days the accelerometer was worn. Adolescents' perceptions of family support for exercise improved following the intervention (p = 0.03). Adolescents who had more daily bouts of exercise lasting 60 min increased their CV fitness (r = 0.59, p = 0.04). A1c remained unchanged. Conclusions: Encouraging 60 min of accumulated exercise bouts/d can improve fitness levels in adolescents with T1DM, minimizing future CV risks. Although physical activity increased in adolescents, family based strategies are required to promote current physical activity recommendations.     

Comparing Activity Patterns,Biological, and Family Factors in Children with and Without Developmental Coordination Disorder

ABSTRACT

The association between motor proficiency and moderate to vigorous physical activity (MVPA) suggests children with developmental coordination disorder (DCD) may be susceptible to inactivity-related conditions such as cardiovascular diseases. The aim of this study was to compare children with and without DCD on physical activity patterns, activity types, body composition, strength, and cardiovascular fitness. Additionally, factors potentially influencing MVPA were also explored. Eighteen children (7–11 years) with and without DCD (n = 9/group) participated. Motor coordination, physical activity, strength, cardiovascular fitness, body mass index (BMI), and family factors were measured. Children with DCD participated in significantly less MVPA and had higher BMIs and decreased strength and cardiovascular fitness. Strength, activity type, and family factors correlated significantly with MVPA for children with DCD. The results suggest that strength, activity types, parent perception of their child's motor abilities, and parent activity participation should be considered to maximize health benefits associated with MVPA for children with DCD.     

Health utility and quality of life in pediatric liver transplant recipients

To measure HU and HRQOL in pediatric liver transplant (LT) recipients, a cross‐sectional study of patient‐parent dyads was conducted. Direct HU were assessed in 48 adolescents ≥12 years using SG and TTO techniques. Indirect HU were measured by Health Utility Index 2 and HUI3 for subjects ≥12 years and CHU9D for ≥7 years. Patients reported HRQOL using PedsQL? GC and PedsQL? TM. A total of 108 dyads participated (55.6% female; 73.2% Caucasian; 42.6% biliary atresia; 35.2% living donor; 37.0% Medicaid). Mean age at survey was 13.6 ± 3.5 years, and time from LT was 8.9 ± 4.9 years. 61.2% were on monotherapy, 25 (23.2%) had acute rejection within 3 years, and 15 (13.9%) had a biliary obstruction within 5 years. Mean indirect HU and HRQOL scores by child report were lower than norms (P < .001). LRD recipients had higher PedsQL? GC, PedsQL? TM, and HUI3 scores (P < .01). HU in pediatric LT recipients are lower than norms. Availability of HU scores for post‐transplant health states will enable measurement of quality‐adjusted life years for future comparative effectiveness studies.     

Feasibility of an inpatient exercise intervention for children undergoing hematopoietic stem cell transplant

With improving survival rates following HSCT in children, QOL and management of short‐ and long‐term effects need to be considered. Exercise may help mitigate fatigue and declines in fitness and strength. The aims of this study were to assess the feasibility of an inpatient exercise intervention for children undergoing HSCT and observe the changes in physical and psychological health. Fourteen patients were recruited, mean age 10 yr. A 6MWT, isometric upper and lower body strength, balance, fatigue, and QOL were assessed prior to Tx and six wk post‐Tx. A supervised exercise program was offered five days per week during the inpatient period and feasibility assessed through uptake rate. The study had 100% program completion and 60% uptake rate of exercise sessions. The mean (±s.d.) weekly activity was 117.5 (±79.3) minutes. Younger children performed significantly more minutes of exercise than adolescents. At reassessment, strength and fatigue were stabilized while aerobic fitness and balance decreased. QOL revealed a non‐statistical trend towards improvement. No exercise‐related adverse events were reported. A supervised inpatient exercise program is safe and feasible, with potential physiological and psychosocial benefits.     

Factors associated with low physical activity levels following pediatric cardiac transplantation

Banks L, Dipchand AI, Manlhiot C, Millar K, McCrindle BW. Factors associated with low physical activity levels following pediatric cardiac transplantation. Abstract: Background: Objectively measured MVPA levels following pediatric cardiac transplantation are unknown despite physical health implications. We sought to determine factors associated with MVPA in a pediatric cohort who had undergone cardiac transplantation. Methods: Study assessments included maximal exercise testing (VO₂max), accelerometry, and physical activity (HAES) and functional health status (CHQ‐PF50) questionnaires. Results: Participants (n = 20, 60% male, age: 11.8 ± 3.0 yr old) had a VO₂max of 28.5 ± 6.8 mL/kg/min (%‐predicted: 65 ± 14%) and maximal heart rate of 154 ± 16 beats/min (%‐predicted: 73 ± 7.5%). Participants performed a median of 7.6 min/day (Q1 4.0 min/day, Q3 11.0 min/day) of MVPA. Each additional year of age at transplantation was associated with a decrease of 1.9 [1.0] min/day of MVPA (p = 0.07). Predicted VO₂max, maximal power output, male sex, and age at study enrollment were not associated with an increase in MVPA. Parents’ perception of their child’s functional health status (CHQ‐PF50) was lower on general health (p < 0.01) and family activity (p < 0.01) domains relative to a population‐based cohort of parents reporting on healthy children. Conclusion: Pediatric cardiac transplantation recipients may be indicated to participate in cardiac rehabilitation to optimize physical activity levels.     

Living donor liver transplantation in Alagille syndrome—Single center experience from south Asia

To analyze the clinical characteristics and the outcomes of living donor liver transplantation in children with Alagille syndrome (AGS). Clinical data of children with AGS who underwent liver transplantation between July 2009 and May 2019 in our unit were retrospectively analyzed. Primary end‐points were patient and graft survival. Ten children with AGS underwent living donor liver transplantation at a median age of 28 months (range, 12‐84 months). Jaundice was the most common initial symptom and was noted after a median duration of 20 days after birth (range, 7‐60 days). Two patients had undergone Kasai porto‐enterostomy for misdiagnosis of biliary atresia. The most common indication for transplantation was severe pruritus with poor quality of life. Explant livers in three children showed cirrhosis with early well‐differentiated hepatocellular carcinoma. We have 100% patient and graft survival at a mean follow‐up of 32 months (range 3‐72 months). The median z‐score for weight and height at liver transplantation was ?2.66 (range: ?6.44 to ?0.9) and ?3.6 (range: ?7.96 to ?0.93) while at follow‐up was ?1.7 (range: ?3.4 to ?0.35) and ?2.1 (range: ?3.9 to ?1.4), respectively. The estimated glomerular filtration rate was normal pretransplant and follow‐up. This is the first series of LDLT for Alagille syndrome in the Indian sub‐continent. We report excellent post‐transplant outcomes in contrast to outcomes reported from Western literature.     

Health-related quality of life in pediatric liver transplant recipients compared with other chronic disease groups

Limbers CA, Neighbors K, Martz K, Bucuvalas JC, Webb T, Varni JW, Alonso EM, on behalf of the Studies of Pediatric Liver Transplantation (SPLIT) Functional Outcomes Group (FOG). Health‐related quality of life in pediatric liver transplant recipients compared with other chronic disease groups.
Pediatr Transplantation 2011: 15: 245–253. © 2010 John Wiley & Sons A/S. Abstract: This cross‐sectional, multicenter cohort study compares the level of HRQOL of pediatric LT recipients to children with other chronic health conditions. LT sample included 873 children who survived at least 12 months following LT. Six chronic disease samples were compiled from numerous studies, including over 800 patients with JRA, type 1 diabetes, cancer in remission, cardiac disease, end‐stage renal disease, and inflammatory bowel disease. Generic HRQOL was measured from both the parental and patient perspective using the PedsQL? 4.0 Generic Core Scales. Pediatric LT patients reported better physical health than children with JRA. According to parents, pediatric LT recipients had better HRQOL than children on renal dialysis on all domains except school functioning. Across all domains but emotional functioning, pediatric LT recipients reported significantly lower HRQOL than children with type 1 diabetes. Overall, pediatric LT patients reported HRQOL comparable to that of children who had undergone renal transplantation and patients with cancer in remission. Pediatric LT patients manifested impaired HRQOL similar to that of children with chronic diseases and these data suggest that they face ongoing challenges that warrant monitoring and indicate a need for interventions to improve their HRQOL.     

Lack of physical activity in young children is related to higher composite risk factor score for cardiovascular disease

Aim: This study evaluates whether accelerometer‐measured physical activity is related to higher composite risk factor scores for cardiovascular disease (CVD) in children. Methods: Cross‐sectional study that included 223 children aged 7.9–11.1 years (boys n = 123, girls n = 100). Daily physical activity was assessed by accelerometers for 4 days. Body fat was quantified by dual X‐ray absorptiometry. Maximal oxygen uptake was measured during a maximal exercise test. Resting heart rate and blood pressure were measured. Z‐scores [(value for the individual ? mean value for group)/SD] were calculated for each variable, and the sum of different risk factor z‐scores used as an index of composite risk factors score for CVD. Results: Partial correlations, from General Linear Model, between moderate to vigorous physical activity (MVPA), vigorous physical activity (VPA) and general physical activity versus index of composite risk factor score were in boys 0.29, 0.33 and 0.30 (all p < 0.05), respectively. The corresponding correlations in girls were ?0.28, ?0.32 (both p < 0.05) and ?0.18 (NS), respectively. Conclusion: Low amounts of MVPA and VPA were related to higher composite risk factor scores for CVD in children aged 8–11 years.     

Locomotive and non-locomotive activity as determined by triaxial accelerometry and physical fitness in Japanese preschool children

This study examined the potential relationship between participation in physical activity (PA) assessed by triaxial accelerometry and physical fitness testing, including health-related and skill-related parameters of fitness, in 136 Japanese preschoolers (65 girls and 71 boys, 5.5 ± 0.6 years). In partial correlation analyses, grip strength and 20m shuttle run test were positively correlated with time spent in physical activity ratio (PAR) ≥ 4. Better scores on standing long jump distance and jump over and crawl under tests were associated with lower sedentary time and greater moderate-to-vigorous PA time and PAR ≥ 4 time, and increased physical activity level. Moreover, 25m run speed was positively correlated with time spent in PAR ≥ 4 and locomotive activity. These findings suggest that development of both health-related (muscle strength and aerobic fitness) and skill-related fitness (power, agility and speed) may make engagement in PA easier for preschool children, although further research on the cause-effect relationship is needed.     

Arterial distensibility is reduced in overweight pre- and early pubescent children

The objective of this study was to examine the differences in arterial distensibility between overweight/obese and normal weight pre- and early pubescent boys and girls. Arterial distensibility was measured in 65 children (43 normal weight and 22 overweight/obese) between the ages of 9 and 12 years. Weight classification was based on age and sex-specific body mass index (BMI) cut-offs and pubertal maturation by Tanner staging. Distensibility was determined using B-Mode echo-Doppler ultrasound to measure changes in the right common carotid artery (CCA) diameter, while carotid pulse pressure was measured at the left CCA by applanation tonometry. Accounting for age and sex (ANCOVA), CCA distensibility showed a significant difference (P < 0.05) between normal weight (0.79 ± 0.21) and overweight children (0.61 ± 0.21 mmHg⁻¹ × 10⁻²). Univariate analysis revealed that CCA distensibility was related to BMI, systolic blood pressure, brachial pulse pressure, and relative oxygen uptake (VO_2peak, milliliter per kilogram per minute). Multivariate analysis revealed that, when adjusting for brachial pulse pressure and relative VO_2peak, differences in CCA distensibility by BMI were no longer significant. This study demonstrates that attenuated arterial distensibility exists in overweight pre- and early pubescent children. As well, this study highlights the influential role of blood pressure and aerobic fitness on arterial distensibility.     

Pretransplant patient,parent, and family psychosocial functioning varies by organ type and patient age

The goal of this study was to compare pretransplant patient HRQOL, parent psychological functioning, and the impact of the patient's ongoing illness on the family between organ types (ie, kidney, liver, heart) and age‐groups (ie, children, AYAs). The sample included 80 pediatric patients with end‐stage organ disease who were evaluated for transplantation and their parents. Parents completed self‐ and proxy reports at patients' pretransplant evaluations. Results indicated that patients evaluated for heart transplants consistently had lower HRQOL and their parents had greater psychological distress compared to the kidney and liver groups. Within the heart group, parents and families of children (<12 years old) experienced significantly more distress and impact of the patient's illness on the family compared to those of AYAs (≥12 years old). Pediatric patients awaiting heart transplants, particularly younger children, and their parents and families may have greater psychosocial needs compared to patients awaiting kidney or liver transplants.     

Physical activity and health related quality of life in children following kidney transplantation

Abstract:  Participation in PA is often diminished in children with CKD. Limited research exists on exercise tolerance/capacity but no studies to date have investigated lifestyle PA and its determinants in these children. The aim of this study was to investigate level of PA and potential physiological and psychological associations in a group of pediatric KTx recipients compared with CS. Twenty KTx and 33 CS participated. PA was measured by PAQ. HRQOL (PedsQL 4.0) and CY-PSPP were also measured. BMI and WC was recorded in all subjects; GFR, BP and immunosuppressants in KTx. Body measurements indicated the two groups were similar: 25% KTx and 24% CS had BMI >85th percentile. KTx were less physically active than CS in total exercise minutes (p = 0.005). CS reported higher HRQOL than KTx (p = 0.001). Higher perceptions of HRQOL were significantly correlated with higher number of steps/day in both groups (p = 0.034). KTx showed significantly lower perceptions of sports competence (p = 0.007) and physical conditioning (p = 0.001) than CS. Higher PAQ activity scores were significantly correlated with higher perceptions of body attractiveness (p = 0.019), Sport (p = 0.003) and Conditioning (p = 0.001). These results suggest that PA may play a role in overall well-being and HRQOL in KTx.     

Long‐term outcomes of liver transplantation for hepatoblastoma: A single‐center 14‐year experience

HB is the most common primary liver tumor in children. Complete tumor excision, either by partial resection or by total hepatectomy and liver transplantation, in combination with chemotherapy provides the best chance for cure. We performed a retrospective analysis of patients who underwent liver transplantation for HB and herein present our 14‐year single‐institution experience. Twenty‐five patients underwent liver transplantation for HB at a median age of 26 months (IQR: 15‐44). Graft survival was 96%, 87%, and 80% at 1, 3, and 5 years, respectively. There were four patient deaths, three of them due to disease recurrence within the first year post‐transplant. Ten‐year overall survival was 84%. Three recipients initially presented with pulmonary metastases and underwent resection of metastatic disease, of which two are alive at 3.9 years. Of three patients who underwent salvage transplants, two are alive at 1.5 years after transplant. Non‐survivors were associated with lower median alpha fetoprotein value at presentation compared to survivors (21 707 vs 343 214; P = .04). In conclusion, the overall long‐term outcome of primary liver transplantation for HB is excellent. Tumor recurrence was the highest contributor to mortality. Even patients with completely treated pulmonary metastases prior to transplant demonstrated a favorable survival.     

Donor‐to‐recipient weight ratio is a risk factor for hepatic artery thrombosis after whole‐liver transplantation in children under 25 kg

Hepatic artery thrombosis (HAT) following pediatric liver transplantation increases morbidity and risk of graft failure. We performed a retrospective chart review of all patients who underwent deceased‐donor liver transplantation from August 2002 to July 2016. Multi‐organ transplant recipients were excluded. We examined the incidence of HAT at our institution and sought to identify associated donor or recipient risk factors. A total of 127 deceased‐donor liver transplant patients with a median age of 1.7 years (IQR 0.67‐6.7) were identified. Of those, 14 developed HAT, all weighing under 25 kg. Among 100 patients under 25 kg, whole‐liver graft recipients had an odds ratio of 3.98 (95% confidence interval [CI]: 1.03, 15.34; P = .045) for developing HAT compared with split‐liver graft recipients. Within the whole‐liver recipient group under 25 kg, 11 patients developed HAT with a median donor‐to‐recipient ratio (DRWR) of 0.9 (IQR: 0.7‐1.2) compared with a median DRWR of 1.4 (IQR: 1.1‐1.9) for those who did not develop HAT. Multivariate analysis showed DRWR to be an independent risk factor for HAT in patients weighing under 25 kg who received whole organ grafts, with an odds ratio of 3.89 (95% CI: 1.43, 10.54; P = .008) for each 0.5 unit decrease in DRWR. Our results suggest that in recipients under 25 kg 1) split‐liver grafts may have a lower rate of HAT and 2) selecting whole organ donors with a higher DRWR may decrease the incidence of HAT.     

Sleep quality is associated with psychosocial functioning and health‐related quality of life in pediatric transplant recipients

This study examined patient‐reported sleep quality in a single‐center cross‐sectional sample of adolescents with solid organ transplants and evaluated associations between sleep quality, psychosocial functioning (ie, depression/anxiety symptoms), and HRQOL. Health disparities associated with minority race/ethnicity and socioeconomic variables were also examined. Sixty‐nine adolescents (M = 16.51 years; SD = 1.63) who received a solid organ transplant (kidney: n = 25; liver: n = 24; heart: n = 20) completed self‐report measures of sleep quality, psychosocial functioning, and HRQOL. Adolescent transplant recipients endorsed significantly lower levels of sleep quality (ie, falling asleep) compared with previously published norms of healthy peers (t = ?3.60; P ≤ .001). Higher sleep quality was significantly associated with fewer anxiety and depressive symptoms (r = ?.31 to ?.40), and higher physical and psychosocial HRQOL (r = .33‐.43). Adolescents from minority backgrounds had significantly worse sleep quality compared with non‐Hispanic Whites. Adolescent transplant recipients, particularly those from minority backgrounds, may be at increased risk for experiencing poor sleep quality. Suboptimal sleep is a risk factor for higher levels of anxiety and depressive symptoms, as well as lower levels of physical and psychosocial HRQOL. Sleep is an important modifiable factor that, if improved, may contribute to lower anxiety/depressive symptoms and better HRQOL in adolescent transplant recipients.     

The longitudinal relationship between motor competence and measures of fatness and fitness from childhood into adolescence

ObjectivesTo examine longitudinal (seven years) relationships among cardiorespiratory fitness (VO_2peak), body fatness, and motor competence.MethodData were collected as part of the Copenhagen School Child Intervention Study (CoSCIS). Body fatness was assessed by the sum of four skinfolds. VO_2peak was measured directly in a continuous running protocol. Motor competence was assessed using the Körperkoordinationtest für Kinder. This study used multilevel linear mixed models to evaluate the reciprocal longitudinal association between body fatness, VO_2peak, and motor competence. All regressions were stratified by sex and adjusted by intervention and pubertal status. All variable coefficients were standardized.ResultsA reciprocal relationship was observed between children's motor competence with body fatness and VO_2peak at the seven-year follow-up (6–13 years of age). Children with higher motor competence at baseline had a lower risk of having higher body fatness (β_boys = −0.45, 95% CI: −0.52 to −0.38; β_girls = −0.35, 95% CI: −0.42 to −0.28) and higher VO_2peak (β_boys = 0.34, 95% CI: 0.27–0.40; β_girls = 0.27, 95% CI: 0.20–0.33) during childhood. Alternatively, higher body fatness or lower levels of VO_2peak at baseline were associated with lower motor competence during childhood.ConclusionsThese data suggest motor competence, body fatness, and VO_2peak demonstrate reciprocal relationships across childhood (6–13 years of age). Interventions addressing motor competence, cardiorespiratory fitness, and body fatness in early childhood are recommended, as intervention effects are likely to be enhanced because of the mutual reciprocal associations between these three variables.     

Physical activity and its correlates in a pediatric solid‐organ transplant population

PA has been shown to have benefits in SOT patients. Studies assessing physical activity levels and its correlates in a pediatric solid‐organ transplant population are limited. The aim of this study was to assess PA levels and identify baseline and contemporaneous factors that contribute to PA in a pediatric SOT population. A retrospective cross‐sectional review was performed on 58 pediatric transplant patients (16 heart, 29 kidney, and 13 liver transplant). PA was measured by PAQ‐C or PAQ‐A. Demographics, baseline, and contemporaneous factors were collected. There were no significant differences in baseline and contemporaneous characteristics between heart, kidney, and liver transplant recipients. SOT recipients were 15.2 [12.3‐17.3] years old at time of completing the PAQ. Median PAQ score was 2.2 [1.7‐2.9]. There were no significant differences in PAQ scores between organ transplant type or between genders. Lower PAQ score was associated with sensory disability (9 vs 49 without disability; P = <.01) and age at time of completing the PAQ (r = ?.50, P = <.01). These results suggest that older age at time of completing the PAQ and presence of sensory disability may influence PA levels in the pediatric SOT population.