Our previous study in a rat lung transplant model using HP [1-13C]-pyruvate MRI demonstrated that an increased lactate-to-pyruvate ratio (LtP) precedes lung rejection. However, most lungs in a clinical setting are obtained after donor brain death (DBD), which is associated with increased ischemia-reperfusion injury and risk of acute lung rejection. In this study, we transplanted DBD-lungs into syngeneic rats and compared the metabolism of DBD-donor lungs to our previous normotensive-donor model. The LtP of the DBD-graft is approximately two-fold higher than that of the other lungs, suggesting that HP [1-13C]-pyruvate imaging can be used to identify grafts with ischemia-reperfusion injury.
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