Clinical Scorecard: Enhancing Outcomes for Infants with Single Ventricle Conditions: Addressing Transplant Referral Gaps?

At a Glance

Key Highlights

• Infant mortality remains high, with rates up to 45% in the first year of life.
• Heart transplant outcomes for HLHS are comparable to other congenital heart diseases.
• Lower rates of transplant referral have been observed in infants from lower socioeconomic statuses and minority races, as indicated by indirect evidence.

Guideline-Based Recommendations

Diagnosis

• Assess prenatal/fetal factors, birth weight, gestational age, and significant tricuspid regurgitation.

Management

• Consider heart transplant for infants with heart failure or high-risk features, as supported by clinical evidence.

Monitoring & Follow-up

• Track outcomes to one year of age, including death, transplant referral, and other early exits.

Risks

• Higher mortality rates have been noted in infants from low SES neighborhoods and minority racial/ethnic backgrounds, according to recent studies.

Patient & Prescribing Data

Infants undergoing Stage 1 palliation for HLHS

Transplant referral patterns may contribute to disparate outcomes.

Clinical Best Practices

• Utilize the Child Opportunity Index to assess neighborhood-level health indicators, as suggested by recent research.
• Implement strategies to improve access to transplant referrals for disadvantaged populations, based on identified disparities.

Related Resources & Content

• NPC-QIC Registry