Developing a Multi-disciplinary Infection Control Protocol for Cross-Perfusion of Porcine Livers

Session Description: Organ transplant is a continuously evolving area of healthcare that is unique due to its reliance on the availability of donated organs. One method being investigated to expand access to transplants is xenotransplantation, which is defined as the transplantation of tissues or organs from one species to another. To date, only porcine kidneys and hearts have been successfully transplanted into human recipients.

Our facility, a large academic medical center, was selected as a first-in-human trial site to assess tolerability of cross-perfusion between a porcine liver and a human recipient via a device used for extracorporeal membrane oxygenation. Cross-perfusion is a less invasive method to evaluate the future feasibility of transplantation of animal-derived organs into humans. Although there are existing infection control guidelines surrounding cardiac or renal xenotransplantation, no guidelines exist for cross-perfusion of a porcine liver.

This presentation will illustrate steps taken after infection prevention received a request to assess the risks posed by this trial and develop a protocol to assist in the management of enrolled participants. By using available guidelines and gathering input from a multidisciplinary group including hospital executive leadership, occupational health, infectious disease, sterile processing, and several other hospital departments, we created a protocol that encompasses management from the time of bedside cross-perfusion cannulation for the remaining duration of hospitalization.

Examples of concerns addressed by this protocol include zoonotic disease transmission from the porcine liver to the patient, staff, or visitors, management of the environment of care, bloodborne pathogen exposure management, and potential impact on hospital operations. Attendees will learn how to utilize existing guidelines and collaborate to develop protocols that ensure safety for all individuals involved with high-risk research. The target audience for this talk is infection preventionists at facilities who are often involved in first-in-human or other novel research trials.

Carlee Hoxworth

Lead Infection Prevention Specialist, Barnes-Jewish Hospital

Carlee Hoxworth MPH, CIC is a Lead Infection Preventionist at Barnes-Jewish Hospital in St. Louis, Missouri where she has worked since August of 2020. She earned a Bachelor of Science degree in Biological Sciences from Southern Illinois University Edwardsville and then went on to complete a Master's in Public Health (MPH) at the Brown School at Washington University in St. Louis where she concentrated on epidemiology and biostatistics. Prior to her current role she worked as a research assistant for molecular mycology and infectious disease research. She is actively involved in her local APIC chapter and has authored the Urinary Tract Infection chapter for the APIC text. Her current areas of focus include infection prevention implications of clinical trials and other research as well as CAUTI and SSI reduction, especially within the neurology and neurosurgery population. Carlee is Board Certified in Infection Prevention and Control.

Grace Myers

Infection Preventionist, Barnes-Jewish Hospital

Grace Myers RN, BSN is an Infection Preventionist at Barnes-Jewish Hospital in St. Louis, Missouri. She earned her Bachelor of Science in Nursing degree from Creighton University in Omaha, NE. Before stepping into the field of Infection Control, Grace spent seven years at the bedside delivering care to patients with hematologic malignancies. Her current areas of focus include CLABSI and CDI reduction in patients undergoing hematopoietic stem cell transplants, instrument reprocessing, and research.

Amy Johnson

Infection Preventionist, HSHS Wisconsin Division

Amy Johnson, BSN, RN, CIC, is an Infection Preventionist with the HSHS Wisconsin Division in Green Bay, WI. She earned her Bachelor of Science in Nursing from the University of Wisconsin–Milwaukee. Amy’s nursing background spans Intermediate/ICU Care, Post‑Anesthesia Care, Gastroenterology, and Clinical Documentation. Amy has been an active leader within the Northeastern Wisconsin (NEW) APIC chapter, serving in both treasurer and president roles. She has also been a dedicated member of the Wisconsin State APIC Seminar Planning Committee for the past several years, contributing to statewide education, collaboration, and professional development.