World’s first HIV-to-HIV lung transplant achieved in the US

Doctors at NYU Langone Health in the United States have made history by successfully performing the world’s first HIV-positive-to-HIV-positive lung transplant. The groundbreaking procedure was carried out on 21 March 2026, marking a historic milestone in medical science that opens new doors for HIV-positive patients in critical need of organ replacement.

It also opens a pool of potential donors who were previously ineligible.‘This is a watershed moment for the HIV-positive community and represents real progress in creating equity in organ transplantation. While these transplants are still only allowable under certain research protocols, this marks an expansion of options for people in need of a life-saving organ,’ Sapna Mehta, MD, clinical director of NYU Langone Transplant Institute and co-architect of the research protocol sanctioned by the US Food and Drug Administration that enabled the complex procedure, said.In the United States, approximately 1.2 million people are living with HIV today. Advances in antiretroviral therapies (ART) have transformed HIV into a manageable chronic condition, with most people on ART living near-normal life expectancies and also being unable to transmit the virus.

A new life

Bertrand Nelson, 56, became the first recipient of this historic procedure. Nelson was diagnosed with HIV about 26 years ago, in 2000.

He was also diagnosed with sarcoidosis, a condition that can affect the lungs and spread to the liver. The disease had not yet spread from his lungs, and soon after diagnosis, his doctors told him it was in remission.In 2021, he contracted Legionnaires’ disease and was hospitalised for weeks with severe pneumonia. The illness reactivated his sarcoidosis, which attacked his liver. By 2024, his condition had worsened, and Nelson required an increasing amount of oxygen to breathe.

That is when doctors referred him to NYU Langone Transplant Institute. At NYU, he was evaluated for both lung and liver transplants. This was in 2025.

He was a candidate for the groundbreaking HOPE dual-organ transplant programme under the 2013 HIV Organ Policy Equity Act, or HOPE Act.‘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 has not been done before,’ Mark A.

Sonnick, MD, transplant pulmonologist at NYU Langone Transplant Institute and co-author of the research protocol with Dr Mehta, said.Interestingly, NYU Langone Transplant Institute is one of the only transplant centres in the United States equipped and approved to perform HOPE lung transplants.So Nelson became the first person in the world to receive an HIV-to-HIV lung transplant. On 21 March 2026, MD, the surgical director of lung transplantation at NYU Langone, performed the historic lung transplant.

He also received a new liver on the same day, which was performed by Karim J. Halazun, MD, surgical director of liver transplantation at NYU Langone.

A breath of fresh air

For the first time in four years, Nelson is now off oxygen. For him, the experience was a breath of fresh air, quite literally. He is getting back into shape after living with limited mobility for years.Nelson is thrilled about the possibility of a new life. He also spoke about his mother, who has always supported him throughout his journey.

She will turn 82 in August.‘I want to be well for her. I want her to see me thriving,’ he said.He also hopes that his perseverance might inspire others and help raise awareness of people in the HIV community in need. ‘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.