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 zonal allocation system for thoracic organs on the outcome of our transplant activity. Methods: We analyzed the results of thoracic transplants performed between 1987 and 1998. The transplants were divided into 3 groups: local donors retrieved by our team (171 hearts and 61 lungs; DL group); distant donors retrieved by our team (58 hearts and 35 lungs; DD group); and distant donors retrieved by other teams (51 hearts and 41 lungs; DX group). Results: No significant differences were observed among the groups in early postoperative events for either heart or lung transplantation. Heart transplants: Cardiac index was 2.6 ± 0.4 L/m2 for the DL group, 2.7 ± 0.6 L/m2 for the DD group, and 2.5 ± 0.7 L/m2 for the DX group (P = .4). The 30-day mortalities were 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. Lung transplants: Alveolar-arterial oxygen gradient was 358 ± 19 mm Hg for the DL group, 345 ± 17 mm Hg for the DD group, and 329 ± 21 mm Hg for the 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 organs has been successfully applied to our program. Using donor organs retrieved by other teams, we have achieved equivalent outcomes for both heart and lung transplantation.