Nutrient digestibility, growth, and mucosal barrier status of fish skin, gills, and distal intestine were studied in Atlantic salmon fed feeds based on marine or plant-derived ingredients. The barrier status was assessed by considering the expression of four mucin genes, five genes that encode antimicrobial proteins, distal intestine micromorphology, and design-based stereology of the midgut epithelium. In addition, the head kidney leukocytes were examined using flow cytometry; to understand the differences in their counts and function. Five experimental feeds containing the main components i) fishmeal and fish oil (BG1), ii) soybean meal (BG2; to induce enteritis), iii) fishmeal as the main protein source and rapeseed oil as the main lipid source (BG3), iv) a mix of plant protein concentrates as the protein sources and fish oil as the lipid source (BG4), and v) plant and marine ingredients in the ratio 70:30 (BG5) were produced for the study. Atlantic salmon with initial weight 72.7 ± 1.2 g was offered the experimental feeds for 65 days. The results revealed that the weights of all fish groups doubled, except for fish fed BG2. Fish fed the BG2 diet had lower blood cholesterol concentration, developed enteritis, had lower expression of muc2 in the distal intestine, and had a compromised barrier status in the intestine. Expression of both the mucin genes and genes that encode antimicrobial peptides were tissue-specific and some were significantly affected by diet. The fish fed BG1 and BG3 had more head kidney lymphocyte-like cells compared to BG5-fed fish, and the phagocytic activity of macrophage-like cells from the head kidney was the highest in fish fed BG1. The intestinal micromorphology and the mucosal mapping suggest two different ways by which plant-based diets can alter the gut barrier status; by either reducing the mucous cell sizes, volumetric densities and barrier status (as noted for BG2) or increasing volumetric density of mucous cells (as observed for BG4 and BG5). The results of the compromised intestinal barrier in fish fed plant ingredients should be further confirmed through transcriptomic and immunohistochemical studies to refine ingredient composition for sustainable and acceptable healthy diets.

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Objectives: To consider that the health-related quality of life (HRQOL) has become an inherent part of the patient outcomes in the care and treatment after kidney transplantation (KT). This study aimed to measure HRQOL among a representative sample size of patients after KT by using both the Short Form 36 (SF-36) and the Kidney Disease Quality of Life 36 (KDQOL-36).Methods and Results: Data of this cross-sectional design were collected in the Organ Transplant Center, Viet Duc University Hospital (Hanoi, Vietnam) from January 2020 to March 2020 and included the patients aged 18 years or over after KT at 6 months, 1 year, and 3 years postoperatively. HRQOL was evaluated through face-to-face interviews by means of the SF-36 and KDQOL-36 measurement tools. According to the SF-36, the overall mean score of HRQOL was 69.13 ± 15.55 and the two domains were the highest scores of “Mental Health” (81.23 ± 14.28) and “General Health” (80.06 ± 14.81). When measuring with the KDQOL-36, the overall mean score was 68.67 ± 13.75 and was the highest in the domain “Symptoms and Problems of Kidney Disease” (87.06 ± 16.00). Both instruments had good reliability for those after KT. The reliability of the SF-36 was high with Cronbach's coefficients α = 0.90. There were positive relationships between the dimensions measured by the KDQOL-36 and SF-36 (correlation coefficient: 0.03–0.69). Similarly, the domains of the SF-36 also had positive correlations with the KDQOL-36 (correlation coefficient: 0.18–0.51). The correlation coefficient between overall HRQOL scores of the SF-36 and KDQOL-36 was 0.62, indicating a strong correlation between the SF-36 and KDQOL-36.Conclusions: There were slight fluctuations in the HRQOL score in domains in the 3-year follow-up stages, suggesting not having clear change. The mean SF-36 score was consistent with the mean KDQOL-36 score. High reliability and strong correlation were found between two instruments of the SF-36 and KDQOL-36. This study provides the reliability and constructs validity in the combination of two sets of the SF-36 and KDQOL-36 scales for the assessment of HRQOL among post-KT patients, thereby assisting physicians and health professionals in the clinical decision-making, assessment of therapeutic efficacy, and understanding of treatment risk.

Laparoscopic donor nephrectomy (LDN) is increasingly popular because of its advantages over open surgery. Chyle leak after donor nephrectomy is a rare but potentially lethal complication if not treated appropriately. We describe a case of a 43-year-old female patient with no remarkable history who presented a chyle leak on day 2 after right transperitoneal LDN. Since conservative treatment failed, the patient underwent magnetic resonance imaging (MRI) and intranodal lipiodol lymphangiography, which confirmed the chyle leak from the right lumbar lymph trunk into the right renal fossa. The chyle leak was percutaneously embolized twice, on postoperative day (POD) 5 and POD 10, by a mixture of N-butyl-2-cyanoacrylate and lipiodol. The drainage fluid decreased significantly after the second embolization. The subhepatic drainage tube was withdrawn on POD 14, and the patient was discharged on POD 17. MRI lymphangiography and intranodal lipiodol lymphangiography effectively identified the chyle leak point. Percutaneous embolization seems to be a safe, effective method for treating high-output chyle leaks.