The NYU Langone Health hospital, in the United States, has carried out the world's first lung transplant between two people with HIV. This complex operation represents a milestone for seropositive patients who require this type of intervention, by incorporating a new group of donors who were previously excluded.
"This is a crucial moment for the seropositive community and represents a true advance in creating equity in organ transplantation," states Dr. Sapna Mehta, clinical director of the NYU Langone Transplant Institute and co-author of the research protocol, approved by the United States Food and Drug Administration, which made this complex procedure possible.
"While these transplants are still only permitted under certain research protocols, this marks an expansion of options for people who need a life-saving organ."
Around 1.2 million people with HIV live in the United States. Advances in antiretroviral therapies (ART) have allowed many of them to enjoy a prolonged and good quality of life. Most people on ART do not transmit the virus and have a life expectancy virtually comparable to that of the general population.
The protagonist of this case is Bertrand Nelson, 56, who has lived with HIV for almost 26 years. In 2000, he was diagnosed with HIV and sarcoidosis, a condition that can affect the lungs and spread to the liver. At that time, the disease had not spread beyond the lungs, and shortly thereafter, doctors informed him that it was in remission.
In 2021, he contracted Legionnaires' disease and was hospitalized for several weeks due to severe pneumonia. This infection reactivated sarcoidosis and ended up damaging his liver. His situation deteriorated further in 2024, when he began to require increasing amounts of oxygen to breathe, and his specialist referred him to the NYU Langone Transplant Institute to evaluate a lung and liver transplant. At that time, a research protocol for lung transplantation under the HIV Organ Policy Equity Act of 2013 (HOPE Act) was already underway, and in 2025 he was evaluated for a double organ transplant under this regulation.
"While heart and abdominal organ transplants from the HOPE program have already been performed, this had not been done in lung transplants. A special type of patient is needed to be willing to undergo something that has not been done before," clarifies Dr. Mark A. Sonnick, a transplant pulmonologist at NYU Langone Transplant Institute and co-author of the research protocol along with Dr. Mehta.
The NYU Langone Transplant Institute is among the few authorized U.S. centers, under a research protocol, to perform HOPE lung transplants. Nelson received the world's first on March 21, 2026, in an intervention led by Dr. Stephanie H. Chang, surgical director of lung transplant at NYU Langone. On the same day, he also received a new liver, transplanted by Dr. Karim J. Halazun, surgical director of liver transplant at the same institution.
After the operation, Nelson has stopped needing oxygen for the first time in four years and is progressively regaining his physical condition after a long period of limited mobility.