*Purpose: Evaluating activity tolerance following heart transplant (HT) provides an objective marker of functional status, can guide cardiac rehabilitation, identifies those patients with increased cardiovascular risk profiles, and may be predictive of adverse outcomes. Therefore, developing novel, reliable, and accessible methods to assess activity and exercise performance in children post-OHT, and which lend themselves to timely interventions, should be a critical goal of post-transplant care.

*Methods: This is an ongoing prospective, observational, biometric study of pediatric HT patients (ages 2-21 years) investigating the use of wearable technologies and corresponding biometric data to assess activity levels. Each subject receives a consumer grade wearable device (Sensomics or Fitbit). Household members are enrolled to serve as healthy controls. The 2-phase project involves a comprehensive evaluation of baseline data, comparison to healthy controls, and correlation to cardiopulmonary exercise tests to assess reliability and feasibility (phase 1) followed by an interventional phase (phase 2) which will involve active monitoring of the clinical data, and discussion with the clinical team if sustained deviations from baseline are noted. Devices remotely monitor heart rate (HR), HR variability (HRV), daily step count, and sleep patterns; daily symptom questionnaires are sent to subjects. All data is uploaded into the MyPHD application, which was designed to integrate wearable device biometric data with other patient-related information.

*Results: Phase 1 is underway with Phase 2 expected to begin by May 2022. There are 36 patients and 110 non-HT family members currently enrolled. Additional biometric data is being collected from 27 kidney, 16 liver, and 8 lung transplant patients to serve as additional points of comparison. Primary analysis of Phase 1 data will be completed by March 2022.

*Conclusions: Preliminary data suggests that using wearing technology to assess activity in children after HT is feasible. We expect that the results of this study will provide novel information about activity levels in children after HT and positively impact the care model of a vulnerable population.

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