A Man With HIV Just Received the World’s First HIV-to-HIV Lung Transplant

The transplant may expand a scarce organ supply for people living with HIV.

Bertrand Nelson had run out of breath, and nearly out of options.

On March 21, 2026, surgeons at NYU Langone Health performed the world’s first lung transplant from an HIV-positive donor to an HIV-positive recipient. Nelson, 56, received a double lung transplant and a new liver the same day — a complex procedure that could widen the donor pool for people with HIV who need lifesaving organs.

It also marks a striking shift in transplant medicine. For decades, HIV-positive donors were shut out of the system, even when their organs might have helped HIV-positive patients.

Once Barred by Law

Thankfully, HIV is no longer the sentence it once used to be. Nelson, who lives in New Jersey, has lived with HIV for more than two decades. Modern antiretroviral drugs can suppress the virus to undetectable levels, allowing many people with HIV to live long lives. People who maintain an undetectable viral load wouldn’t even transmit the virus via sexual contct.

That success has brought a new medical challenge. As people with HIV age, more develop serious heart, lung, liver, and kidney disease. Some eventually need transplants.

For years, federal law blocked organs from HIV-positive donors, even for HIV-positive recipients. That changed with the 2013 HIV Organ Policy Equity Act, or HOPE Act, which allowed such transplants under research safeguards.

Kidney and liver transplants from HIV-positive donors have since become more common. Hearts and lungs remain more restricted, because doctors have less evidence about safety and long-term outcomes.

“This is a watershed moment for the HIV-positive community and represents real progress in creating equity in organ transplantation,” Dr. Sapna Mehta of NYU Langone said in a NYU Langone press release. “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.”

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The Patient Who Said Yes

Nelson was diagnosed in 2000 with HIV and sarcoidosis, an inflammatory disease that can scar organs, especially the lungs. His sarcoidosis went into remission for years.

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Then, in 2021, he developed Legionnaires’ disease, a severe pneumonia caused by Legionella bacteria. The infection reactivated his sarcoidosis. His lungs worsened quickly, and his liver was also affected. By 2024, he needed more and more oxygen to breathe.

After another transplant program turned him down, Nelson went to NYU Langone, where doctors evaluated him for a dual lung-and-liver transplant under a HOPE Act research protocol sanctioned by the Food and Drug Administration.

“Transplantation of HOPE hearts and abdominal organs has been done before, but this has not been done in lung transplantation,” said Dr. Mark A. Sonnick, a transplant pulmonologist at NYU Langone. “It takes a special kind of patient to be willing to do something that hasn’t been done before.”

Nelson went into respiratory arrest on the operating table but doctors managed to revive him. He spent 67 days in the hospital before returning home.

“You Are Worthy”

The operation does not mean HIV-positive lung donation will become routine right away. Researchers still need to track outcomes carefully, including rejection, infection risk, and how antiretroviral drugs interact with transplant medicines.

But the case shows that HIV-positive donors may help ease an organ shortage that leaves many patients waiting.

Nelson is now off oxygen for the first time in four years, according to NYU Langone. He hopes his recovery will challenge old assumptions about HIV and will help more people receive life-saving treatment.

“You are worthy,” he told Scientific American, speaking to other people with HIV who need transplants.

He also wants more people with HIV to know they are eligible to become donors. “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 in the NYU Langone press release.

For now, Nelson’s case will be watched closely. If his recovery holds and future patients do well, HIV-positive lung donation could move from a rare research procedure to another way to shorten the transplant waitlist. For patients who once had fewer options, that would be the real milestone.