Introduction: The health benefits of physical activity (PA) are well established and include improved cardiovascular health, decreased levels of obesity, improved bone health and improved psychological wellbeing. Prior research suggests that following kidney transplant children have lower levels of cardiorespiratory fitness and reduced participation in PA. It is suggested that parents and children may be reticent to participate in PA due to perceived risk of adverse effects of activity post –transplant, eg, kidney injury. Children after transplant also have a higher BMI and a number of other cardiovascular risk factors which predispose them to cardiovascular morbidity. PA may be a useful tool to improve physical fitness and control weight gain as well as improve quality of life and long term health for children and adolescents after transplant. This study aims to describe the PA levels of children and young people over 12 months after kidney transplant and also identify barriers to PA as reported by children and families. We also aim to explore associations between BMI, strength, fitness, quality of life and levels of PA.
Methods: This is a cross-sectional study with children and adolescents (5 – 16 years) more than 12 months after renal transplant. Data collection includes participant reported PA (7 day recall), PA measured with a physical activity monitor (activPAL) and surveys of perceived barriers to PA and health-related quality of life (PedsQL). Functional measures of fitness (6-minute walk), strength (30 second chair rise test) and anthropometric measures are compared to PA levels.
Results: Data collection commenced in February 2019 and is ongoing. To date 20 (of an expected 50) participants have been recruited. Demographics: average age 11 years 8 months; 60% male; mean age at transplant 7 years. Mean BMI: 20.39.  PA Measures (Mean (SD)): 6-min walk 477.6 (72.23) metres; 30 sec sit to stand 17.35 (3.44) reps; Steps per day 8371 (3258).  Self-reported PA was below peer average for both primary and secondary school. Major barriers reported: finding time, limitation of health condition, risk of kidney damage, preference for video games and TV, child too tired, other priorities. Facilitators to PA: desire to improve health and maintain healthy weight, somewhere safe nearby. 
Conclusions: There is wide variability in the physical activity levels of children and adolescents after renal transplant. Overall physical activity, strength and fitness are reduced compared to peers.  Parents report an understanding of the importance of physical activity in improving health and maintaining a healthy weight.  Despite this there remain many barriers to physical activity which include fear of injury, time, health condition and children’s preference for sedentary activities. Therefore we see  potential for an intervention  and hope to conduct future research to trial a health coaching approach to supporting children and families to be more active.