World's first HIV-to-HIV lung transplant offers new hope for patients awaiting organs

The world’s first lung transplant between two people living with HIV in New York City on March 21, 2026, is now expected to reshape organ allocation policies for people living with HIV in the United States, where about 1.2 million individuals are estimated to be living with the condition, according to the Centers for Disease Control and Prevention. 

In 2022 alone, approximately 31, 800 people acquired HIV in the country. According to the data, in 2022, 37,981 people aged 13 or above received an HIV diagnosis in the U.S. and associated states. 

The surgery was performed at NYU Langone Health. The patient, Bertrand Nelson, 56, received both a lung and a liver on the same day. He had been living with HIV for nearly 26 years and his health had been declining steadily since 2021. He is now off supplemental oxygen for the first time in four years. 

The procedure was carried out under a research protocol approved by the US Food and Drug Administration. It was made possible by the HIV Organ Policy Equity Act, known as the HOPE Act, passed in 2013. Before the HOPE Act, organs from HIV-positive donors could not be transplanted into any patient, regardless of the recipient's HIV status. The act changed that. Transplants involving HIV-positive donors and HIV-positive recipients of hearts, kidneys, and liver have since been performed. This lung transplant, however, is the first of its kind anywhere in the world. 

"This is a watershed moment for the HIV-positive community and represents real progress in creating equity in organ transplantation," said Sapna Mehta, clinical director of the NYU Langone Transplant Institute and co-architect of the research protocol. "While these transplants are still only allowable under certain research protocols, this marks an expansion of options for people in need of a lifesaving organ.”  

In India, over 2.5 million people are living with HIV, as per the government data. Annual new HIV infections were estimated at 66,400, which is a reduction of 44 per cent since 2010.  

Nelson’s Life

Nelson was diagnosed with HIV and sarcoidosis in 2000. Sarcoidosis is a condition where clusters of inflammatory cells form in the body's organs, most commonly in the lungs. At the time of diagnosis, the disease had not spread from his lungs.  

In 2021, he contracted Legionnaires' disease, a severe form of pneumonia, and was hospitalised for weeks. The illness reactivated his sarcoidosis, which this time attacked his liver. By 2024, he needed increasing amounts of supplemental oxygen to breathe and was referred to the NYU Langone Transplant Institute for evaluation for both lung and liver transplants. He was assessed for what is called a HOPE dual-organ transplant in 2025 and underwent the surgery in March 2026. 

"Transplantation of HOPE hearts and abdominal organs has been done before, but this has not been done in lung transplantation. It takes a special kind of patient to be willing to do something that hasn't been done before," said Mark Sonnick, transplant pulmonologist at NYU Langone Transplant Institute and co-author of the research protocol. 

The lung surgery was performed by Stephanie Chang, surgical director of lung transplantation at NYU Langone. The liver surgery on the same day was carried out by Karim Halazun, surgical director of liver transplantation.  

NYU Langone Transplant Institute is described as one of the only transplant centres in the United States equipped and approved under a research protocol to perform HOPE lung transplants. 

Nelson is now recovering. He is off supplemental oxygen and has begun rebuilding his physical fitness after years of limited movement. He credits his mother, who will turn 82 this August, for supporting him through the process. 

"I want to be well for her," he said. "I want her to see me thriving." 

He also spoke about others in the HIV community who are waiting for organs. "There are so many others who need access to this level of care, and the more organs that become available, the better the odds of finding the right match and living a long life," he said. 

The procedure remains under a research protocol and is not yet standard medical practice. NYU Langone is one of the few centres in the country authorised to carry it out under the HOPE Act framework.  

“People with HIV can live long, healthy lives due to advances in antiretroviral therapies, or ART. Most people using ART are unable to transmit the virus and have near-normal life expectancies,” the press release noted. 

This story is done in collaboration with First Check, which is the health journalism vertical of DataLEADS