Post-transplant lungs are clinically monitored using regular radiography and/or CT scans to detect rejection. We proposed that a metabolic biomarker may provide higher sensitivity than conventional tools at the onset of rejection, before permanent structural changes in the lungs. Using HP [1-13C] pyruvate CSI, we found that the HP lactate-to-pyruvate ratio in the transplanted lung was significantly elevated in the rejected cohort (~1.7-fold on day 3, ~2.7-fold on day 7) compared to the non-rejected cohort and can be potentionally used as an early predictor of lung rejection.
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