In a notable step for transplant medicine, surgeons at NYU Langone Health have completed the world's first lung transplant from an HIV-positive donor to an HIV-positive recipient. The procedure, performed on March 21, 2026, also included a new liver for Bertrand Nelson, a 56-year-old New Jersey patient.
The case is drawing attention because it expands the possibilities for people living with HIV who need organ transplants. For many years, HIV-positive donors were excluded from the transplant system, even when their organs could have been suitable for HIV-positive recipients.
A Shift in Transplant Access
That landscape began to change with the HOPE Act, passed in 2013, which opened the door to organ transplants between HIV-positive donors and recipients under research oversight. Since then, kidney and liver transplants have become more common in this setting, while lungs and hearts have remained far less explored.
Nelson has lived with HIV for more than two decades and was also diagnosed with sarcoidosis, an inflammatory condition that can damage organs. After a later bout of Legionnaires' disease worsened his breathing and affected his liver, he needed a complex transplant option. Under an FDA-sanctioned research protocol, NYU Langone evaluated him for the combined procedure.
Doctors say the operation represents an important proof of concept for future care. It also highlights how advances in antiviral treatment have transformed HIV into a manageable condition for many people, creating new questions and opportunities in long-term health planning.
During the surgery, Nelson briefly experienced respiratory arrest but was revived by the team. He spent 67 days recovering in hospital before returning home, and he is now off oxygen for the first time in four years.
Researchers will continue monitoring outcomes such as rejection, infection risk, and how transplant medications interact with antiretroviral therapy. If results remain strong, this milestone could help broaden the donor pool and reshape access to lifesaving organs for more patients in the years ahead.