BREATH PENTANE IS A MARKER OF ACUTE CARDIAC ALLOGRAFT-REJECTION

Breath pentane, a product of lipid peroxidation that serves as a nonin vasive marker of tissue inflammation and injury, was measured as a pot ential marker of acute cardiac allograft rejection. We prospectively s tudied 37 consecutive outpatients with stable cardiac allograft functi on. Breath pentane levels were measured with gas chromatography, and t he results were compared the findings from routine surveillance endomy ocardial biopsy. Data analysis was performed with the receiver operati ng characteristic curve and negative and positive predictive values. S tatistical methods include analysis of variance and two-sample-t-tests . Histopathologic findings consistent with rejection were present on e ndomyocardial biopsy in 52% of the subjects. Pentane levels in healthy control subjects did not differ from those of patients undergoing tra nsplantation without rejection. Average pentane excretion for subjects with mild rejection (4.2 +/- 2.8 nmol/L) or moderate rejection (5.4 /- 2.6 nmol/L) exceeded that seen in subjects who did not have rejecti on (1.7 +/- 0.9 nmol/L) (p < 0.02). A pentane cutoff value of 2.43 nmo l/L, chosen to give the highest negative predictive value, had a sensi tivity of 0.80. We concluded that breath pentane excretion is a sensit ive noninvasive screening test for the detection of cardiac allograft rejection.