Can HIV-Positive-to-HIV-Positive Lung Transplants Save More Lives?

• People living with HIV who develop end-stage lung disease have historically faced major barriers to transplantation, including a limited donor pool and concerns about post-transplant outcomes.
  
  Now, a landmark procedure at NYU Langone Health has challenged those barriers by successfully performing the world's first lung transplant from an HIV-positive donor to an HIV-positive recipient. ()
  
  The groundbreaking surgery, performed under the HIV Organ Policy Equity (HOPE) Act research framework, could expand access to lifesaving organs for people living with HIV and help address organ shortages.
  
  According to NYU Langone Health, the procedure demonstrates that HIV-positive donor lungs may become a viable option for carefully selected HIV-positive transplant candidates, offering new hope to patients who previously had fewer opportunities for transplantation.
  
  

  Could HIV-Positive Donor Lungs Expand Transplant Access?

  According to NYU Langone Health, the world's first HIV-positive-to-HIV-positive lung transplant was performed on March 21, 2026, at its Transplant Institute. The recipient, 56-year-old Bertrand Nelson, had been living with HIV for nearly 26 years and was suffering from severe lung and liver disease.
  
  The procedure was carried out under a U.S. Food and Drug Administration-approved research protocol enabled by the 2013 HOPE Act, which allows the transplantation of organs from HIV-positive donors to HIV-positive recipients within approved research studies.
  
  Dr. Sapna Mehta, clinical director of the NYU Langone Transplant Institute, described the operation as a major step toward improving transplant equity for people living with HIV. According to NYU Langone Health, the surgery opens access to a donor pool that was previously unavailable to these patients.
  
  While HIV-positive donor heart, kidney, and liver transplants have been performed before under HOPE Act protocols, lung transplantation from an HIV-positive donor had never been successfully completed. Dr. Mark Sonnick, transplant pulmonologist at NYU Langone and co-author of the research protocol, noted that this represented an entirely new frontier in thoracic transplantation.
  
  

  Are Lung Transplants Safe for People Living With HIV?

  The historic transplant builds on growing evidence that people living with HIV can achieve outcomes similar to those of HIV-negative transplant recipients.
  
  According to a recent study published in the journal Transplantation, researchers analyzed outcomes from 59 lung transplant recipients living with HIV and compared them with 236 HIV-negative recipients. The study found no significant difference in survival rates between the two groups.()
  
  One-year survival was 91.2% among recipients living with HIV compared with 88.6% in HIV-negative recipients. Three-year survival rates were also comparable at 82.6% and 77.8%, respectively.
  
  Researchers concluded that people living with HIV should be considered suitable candidates for lung transplantation when appropriately selected and managed.
  
  Additional evidence published in BMJ Case Reports noted that advances in antiretroviral therapy have transformed HIV into a manageable chronic condition, allowing many individuals to live long lives and develop age-related illnesses such as chronic lung disease. ()
  
  The report highlighted that careful candidate selection and close monitoring can result in favorable transplant outcomes for HIV-positive patients.
  
  According to NYU Langone Health, approximately 1.2 million people in the United States are living with HIV. Modern antiretroviral therapies allow most patients to achieve near-normal life expectancy and prevent transmission of the virus when treatment is maintained.
  
  

  How Did One Patient Make Medical History?

  Nelson's health challenges began long before the transplant. He was diagnosed with HIV and sarcoidosis in 2000. Although his sarcoidosis initially remained under control, his condition worsened after he developed Legionnaires' disease in 2021.
  
  The infection reactivated his sarcoidosis, causing progressive damage to both his lungs and liver. By 2024, he required increasing amounts of supplemental oxygen and was referred to NYU Langone for evaluation.
  
  After qualifying for the HOPE Act research program, Nelson underwent a dual-organ transplant in March 2026, receiving both new lungs and a new liver during the same operation.
  
  According to NYU Langone Health, the results have been life-changing. For the first time in four years, Nelson no longer requires supplemental oxygen and is rebuilding his strength after years of limited mobility.
  
  He hopes his experience will raise awareness about organ transplantation within the HIV community and encourage broader access to advanced treatments.
  
  As more HIV-positive donor organs become available through research programs such as the HOPE Act, experts believe many more patients could benefit from lifesaving transplants that were once considered impossible.
  
  The success of this first HIV-positive-to-HIV-positive lung transplant marks an important milestone in transplant medicine and may help redefine what is possible for people living with HIV who develop advanced lung disease.
  
  References:

  1. World�s 1st HIV-to-HIV Lung Transplant Performed at NYU Langone Health - (http:nyulangone.org/news/worlds-1st-hiv-hiv-lung-transplant-performed-nyu-langone-health)
  2. Lung Transplantation for People Living With HIV: Promising Mid-term Outcomes - (https:journals.lww.com/transplantjournal/abstract/2024/04000/lung_transplantation_for_people_living_with_hiv_.27.aspx)
  3. Lung transplant in chronic HIV infection - (https:pmc.ncbi.nlm.nih.gov/articles/PMC10649389/)

  
  
  Source-Medindia