The world’s first HIV-positive-to-HIV-positive lung transplant was performed at NYU Langone Health, and this is said to “bring new hope for HIV-positive patients in need of lung transplants, as it 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,” said Sapna Mehta, MD, clinical director of NYU Langone Transplant Institute and co-architect of the research protocol, sanctioned by the U.S. Food and Drug Administration, that enabled the complex procedure. “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 2025, approximately 40.9 million people globally were living with HIV. 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.
Bertrand Nelson, 56, has had HIV for nearly 26 years. In 2000, he was diagnosed with HIV and sarcoidosis, which 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.
Then, in 2021, he acquired Legionnaires’ disease and was hospitalized for weeks with severe pneumonia. The disease reactivated his sarcoidosis, which attacked his liver. His condition worsened in 2024—he required an increasing amount of oxygen to breathe—and his doctor referred him to NYU Langone Transplant Institute to be evaluated for both lung and liver transplants. A research protocol for lung transplantation under the 2013 HIV Organ Policy Equity Act, or HOPE Act, had begun, and he was evaluated for HOPE dual-organ transplant in 2025.
“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 A. Sonnick, MD, transplant pulmonologist at NYU Langone Transplant Institute and co-author of the research protocol with Dr. Mehta.
NYU Langone Transplant Institute is one of the only transplant centers in the US equipped and approved under a research protocol to perform HOPE lung transplants. Nelson received the first in the world on March 21, 2026, by Stephanie H. Chang, MD, surgical director of lung transplantation at NYU Langone. He received a new liver that same day, performed by Karim J. Halazun, MD, surgical director of liver transplantation at NYU Langone.
Nelson is now off oxygen for the first time in four years and getting back in shape after years of limited mobility.
He credits his mother, who will be 82 in August, for always supporting him and helping him throughout his journey. “I want to be well for her. I want her to see me thriving.”
He hopes his story of 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 ended.
