HIV-positive lung transplant changes organ rules worldwide

world-first HIV-positive – A 56-year-old man living with HIV in New Jersey received a successful double lung and liver transplant from an HIV-positive deceased donor in a surgery performed at NYU Langone Health in New York City. The world-first case, enabled by the 2013 HOPE Act and NYU

For decades, the idea of receiving an organ from someone who had HIV has been surrounded by fear, rules, and the kind of stigma that follows people long after treatment works. On March 21, Bertrand Nelson—56 years old, living with HIV for more than 20 years—walked through a different reality.

He received a double lung and liver transplant from a deceased donor who was also HIV-positive. The operation was successful, and Nelson was discharged home a couple of weeks ago.

Nelson says he is glad he got the transplant. but he is equally determined to challenge how people living with HIV are treated—especially the assumptions that strip them of options. He wants people with HIV to know they can be organ donors. and that doing so could save the life of one person—or even several. For those who need a transplant, his message is blunt and personal: “you are worthy.”.

He also carries gratitude toward his donor and the donor’s family. “Those of us who are recipients, we never forget the donor,” he says.

His case landed at a moment when the medical stakes for people with HIV are rising. Antiretroviral drugs have transformed HIV into a condition that can be suppressed to undetectable levels in the body. allowing many people to live much longer. Longer lives come with the kinds of age-related health problems that once seemed less common—end-stage heart or lung disease among them. As a result, the need for organ transplants among people with HIV has been growing.

Sapna Mehta. the clinical director of the NYU Langone Transplant Institute and co-architect of the research protocol that enabled Nelson’s lung transplant. frames the milestone in terms of care. “It’s a milestone for a few reasons,” she says. “It’s a real testament to how far we have come in the care of patients with HIV. They are living long lives and are able to be organ donors.”.

What makes Nelson’s surgery historic isn’t just that the transplant happened. It’s what was transplanted—and from whom. The lung transplant at NYU Langone is the world’s first transplant of lungs from an HIV-positive donor to an HIV-positive recipient. HIV-positive recipients could already receive organs from HIV-negative donors. but this step changes the supply picture by bringing more potentially transplantable organs into reach at a time when organs are in seriously short supply.

The legal pathway for this shift traces back to the HIV Organ Policy Equity (HOPE) Act. Passed in 2013 under then-President Barack Obama, the law allows people with HIV to donate organs to others with the infection. Before the HOPE Act, it had been a federal crime to transplant organs from someone who was HIV-positive.

Even with that law, the details mattered. Since the program began. people living with HIV have been able to receive kidneys or livers from HIV-positive donors. but until 2024. those surgeries were done as part of a research program and required approval from an independent review board. Under the Biden Administration. the Department of Health and Human Services amended this rule. enabling kidney and liver transplants from HIV-positive donors to take place outside of research. Still, transplants with hearts and lungs remained considered too experimental.

In Nelson’s case, the surgery was performed by surgeons at NYU Langone Health in New York City.

His health story helps explain why time was so unforgiving. Nelson was diagnosed with HIV and sarcoidosis in 2000. Sarcoidosis causes pockets of immune cells to accumulate throughout the body, especially the lungs. After Nelson received treatment, his sarcoidosis went into remission for 20 years.

Then, in 2021, Legionnaire’s disease—described as a severe form of pneumonia caused by the Legionella bacteria—reactivated his sarcoidosis. His lung function declined rapidly. He was put on oxygen, and by the fall of 2024, he needed a lung transplant.

When one program said no, he kept searching. After being declined by a transplant program in Pennsylvania. Nelson approached NYU Langone. where he began the “arduous” process of being evaluated for transplant listing. He got on the list on October 2. 2024. and just months later. he received the call that a pair of lungs and a liver were available.

On the operating table, the moment tightened. Nelson went into respiratory arrest. “They lost me on the table,” he says. Doctors resuscitated him. and he spent 67 days in the hospital before they discharged him home to New Jersey. where his 81-year-old mother has been caring for him with the help of a cousin.

“My mother is such a strong woman,” Nelson says. “She’s really a cool cat.” In 2017, she had cared for his brother after a kidney transplant, so she had experience taking care of someone after a transplant.

Nelson says he is doing well mentally, but he is still weak after spending so long in hospital. He hopes to start physical therapy soon.

There’s also a final, quieter reminder that medicine is never a clean timeline: an update issued by the outlet that published the reporting notes that the article was updated on 6/19/26 to correct a detail about Bertrand Nelson’s operation.

In a world where organ access can hinge on infection status and where the fear of rejection can be just as heavy as illness. Nelson’s case has already done something concrete. It turned an “experimental” boundary into a real. discharged patient—one who now wants others to hear a message he says he needed to believe long before the call for lungs came through.

HIV lung transplant HOPE Act NYU Langone Health organ donation sarcoidosis Legionnaire’s disease transplant policy