Zonal allocation for thoracic organs in the United Kingdom: Has it been successful? A single-center view

Objectives: The purpose of this study was to analyze the impact of the zona l allocation system for thoracic organs on the outcome of our transplant ac tivity, Methods: We analyzed the results of thoracic transplants performed between 1987 and 1998. The transplants were divided into 3 groups: local do nors retrieved by our team (171 hearts and 61 lungs; DL group); distant don ors retrieved by our team (58 hearts and 35 lungs; DD group); and distant d onors retrieved by other teams (51 hearts and 41 lungs; DX group). Results: No significant differences were observed among the groups in early postope rative events for either heart or lung transplantation. Heart transplants: Cardiac index was 2.6 +/- 0.4 L/m(2) for the DL group, 2.7 +/- 0.6 L/m(2) f or the DD group, and 2.5 +/- 0.7 L/m(2) for the DX group (P = .4), The 30-d ay mortalities mere 9.1%, 9.1%, and 8.3% (P = .5) and the 1-year survivals 83%, 80%, and 82% (P = .4) for the DL, DD, and DX groups, respectively. Lun g transplants: Alveolar-arterial oxygen gradient was 358 +/- 19 mm Hg for t he DL group, 345 +/- 17 mm Hg for the DD group, and 329 +/- 21 mm Hg for th e DX group (P = .07), The 30-day mortalities were 9.9%, 10.5%, and 12.8% (P = .2) and the 1-year survivals 79%, 75%, and 77% (P = .3) for the DL, DD, and DX groups, respectively. Conclusion: Zonal allocation for thoracic orga ns has been successfully applied to our program. Using donor organs retriev ed by other teams, we have achieved equivalent outcomes for both heart and lung transplantation.