Background：From 2021 to 2024, our hospital conducted two cases of genetically-engineered (GE) pig kidney xenotransplantation and one GE pig red blood cell (pRBC) xenotransfusion in brain-dead human subjects as preclinical xenotransplantation models. The specialized care provided by nursing staff played a critical role in these trials, requiring adaptation to unique challenges. This study aims to explore practical insights gained from the care of brain-dead subjects undergoing xenotransplantation and xenotransfusion, with the goal of educating nursing staff and identifying the essential components of specialized nursing care for these procedures. The focus is on optimizing care strategies and addressing key challenges related to infection prevention, hemodynamic management, and pressure ulcer prevention.
Methods: Nursing care protocols were developed to meet the specific needs of these patients, with an emphasis on pressure ulcer prevention through frequent repositioning and the use of specialized bedding. Infection prevention strategies, particularly targeting respiratory infections, were reinforced by a two-week antibiotic regimen. Hemodynamic stability was ensured through continuous monitoring and the careful adjustment of vasopressors and fluid administration according to the patient's condition.
Results: In the two kidney xenotransplantation cases, rejection occurred after 10 days, while the xenotransfusion case concluded as planned after 14 days. The nursing team successfully implemented preventive measures, minimizing pressure ulcers and infections. Hemodynamic stability was maintained through timely interventions using vasopressors and fluids.
Care optimization: In order to prevent the occurrence or further spread of pressure sores, in the nursing process, in addition to frequent turning over and reducing the pressure time in the same place, air cushion bed and hydrocolloid excipients can be used to protect the pressure part, and joint massage and other measures can effectively reduce the occurrence of pressure sores.
Challenges: In the process of nursing, the biggest challenge we face is the management of fluids and the principle of fluid rehydration according to the positive and negative balance mechanism of patients. However, the recessive intake and recessive water loss of patients have not been calculated more accurately. 
Conclusion: Nursing care for brain-dead subjects involved in xenotransplantation and xenotransfusion trials presents unique challenges and requires specialized approaches. The practical insights gained from these cases underscore the critical role of nursing in supporting advanced xenotransplantation research. These insights are invaluable for preparing for future preclinical trials involving brain-dead subjects and lay the foundation for the eventual clinical application of xenotransplantation in living human patients.