Zonal allocation for thoracic organs in the united kingdom: Has it been successful? A single-center view.
OBJECTIVE
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/m(2) for the DL group, 2.7 +/- 0.6 L/m(2) for the DD group, and 2.5 +/- 0.7 L/m(2) 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.


CONCLUSIONS
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.
Aziz
T
T
Cardiac Transplant Unit, Wythenshawe Hospital, Manchester, United Kingdom.
Burgess
M
M
Rahman
A
A
Campbell
C
C
Deiraniya
A
A
Yonan
N
N
D000206:Actuarial Analysis; D000328:Adult; D000704:Analysis of Variance; D002302:Cardiac Output / Q000502:physiology; D016009:Chi-Square Distribution; D016001:Confidence Intervals; D005500:Follow-Up Studies; D015276:Health Care Rationing; D016027:Heart Transplantation / Q000502:physiology; D016041:Heart-Lung Transplantation / Q000502:physiology; D006801:Humans; D016040:Lung Transplantation / Q000502:physiology; D017063:Outcome Assessment, Health Care; D011659:Pulmonary Gas Exchange / Q000502:physiology; D012189:Retrospective Studies; D015996:Survival Rate; D014019:Tissue Donors / Q000600:supply & distribution; D009927:Tissue and Organ Procurement / Q000379:methods*; D016896:Treatment Outcome; D006113:United Kingdom