Introduction: Critical care nursing involvement in xenotransplant research is crucial to the advancement of preclinical studies in brain dead decedents.

Methods: Following the establishment of research protocols and approval by the Research on Decedent Oversight Committee, all intensive care unit (ICU) nurses (RNs) participating in xenotransplant research were on-boarded and trained by the xenotransplant research team. Research protocols and standard operating procedures were reviewed. The risk of transmission of porcine endogenous retrovirus (PERV), which is carried within the genome of pig species, and plan for passive surveillance for personnel exposed during the xenograft was also discussed. 

Results: ICU RNs managed several devices including arterial lines, pulmonary arterial catheters, continuous renal replacement therapy (CRRT), ventilator, central lines, and urinary catheters. The decedents were monitored in an ICU-like setting in collaboration with the intensivist. Data collected included hemodynamic parameters, ventilator settings, CRRT data, chest tube output, fluid intake, urinary output, and relevant infusion doses over the 66-hour period. In addition to routine lab draws, inflammatory markers such as specific cytokine levels were drawn to assess for systemic inflammation and xenograft rejection. Upon completion of the experiments, the xenograft hearts were explanted, and postmortem care and interment were conducted in accordance to the family’s wishes. Evidence-based nursing guidelines, in conjunction with research protocols, were followed throughout the duration of the experiments. The ICU RN experience was similar to the care of an allotransplant heart recipient with unique nuances from both a decedent and xenotransplant perspective. 

Conclusions: This groundbreaking research study provided ICU RNs the unique opportunity to actively participate in xenotransplant research and collaborate directly with the research team and care for a decedent in a unique setting. The experience pushed the boundary of nursing excellence in transplant science with the support of institutional nursing leadership. The goal is to share the experience and encourage other centers to engage ICU RNs in this exciting field of research that will help to advance the science of medicine and nursing.