A 44/45 caliber hole through both lungs of any deer or elk will kill it. The advantage of a big hardcast slug is that it penetrates and will also break major bones.
I shot this elk at 250 yards with a 400 Whelen using a 350 gr Barnes old X. It took out both lungs and only made a .411 hole through them as it was going about handgun speed at that range. He walked in a small circle, bedded and was dead by the time we bushwhacked over to him.
Had it been 40 yards with a 300 gr hardcast from my 44 Magnum, I believe the results would have been the same.
I will admit good tracking skills are required if the animal takes off. Growing up as a bowhunter and deerslug hunter back East, you had to have those skills.
Of course if you shot that deer or elk through both shoulders, there would be no tracking.