The world’s first HIV-to-HIV lung transplant was performed at NYU Langone Health.
The surgery brings new hope for HIV-positive patients in need of lung transplants as it opens up 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 the NYU Langone Transplant Institute and co-architect of the US Food and Drug Administration-approved research protocol that made the complex procedure possible. “While these transplants are still only allowed under specific research protocols, this marks an expansion of options for people who need a life-saving organ.”
About 1.2 million people in the United States are living with HIV. People with HIV can live long, healthy lives because of advances in antiretroviral therapies, or ART. Most people using ART cannot transmit the virus and have an almost normal life expectancy.
A breath of fresh air
Bertrand Nelson, 56, had HIV for almost 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 the diagnosis, doctors told him he was in remission.
Then, in 2021, he contracted Legionnaires’ disease and was hospitalized for weeks with severe pneumonia. The disease reactivated his sarcoid, which attacked his liver. His condition worsened in 2024—he needed increasing amounts of oxygen to breathe—and his doctor referred him to NYU’s Langone Transplant Institute to be evaluated for both lung and liver transplants. It had initiated an investigational lung transplant protocol under the HIV Organ Policy Equity Act of 2013, or HOPE Act, and was evaluated for a HOPE double organ transplant in 2025.
Transplantation of HOPE hearts and abdominal organs has been done in the past, but this has not been done in lung transplantation. It takes a special kind of patient to be willing to do something that has never been done before.”
Mark A. Sonnick, MD, a transplant pulmonologist at NYU Langone Transplant Institute and co-author of the research protocol with Drs. Mehta
NYU Langone Transplant Institute is one of the only transplant centers in the United States equipped and research protocol approved to perform HOPE lung transplants. Nelson received the world’s first on March 21, 2026, from Stephanie H. Chang, MD, surgical director of lung transplantation at NYU Langone. He received a new liver the same day, performed by Karim J. Halazun, MD, surgical director of liver transplantation at NYU Langone.
Nelson is off oxygen for the first time in four years and is getting back into shape after years of limited mobility.
He credits his mother, who will be 82 in August, for always supporting him and helping him along the way.
“I want to be good with her,” he said. “I want him to see me prosper.”
He hopes his story of perseverance can inspire others and help raise awareness for people in the HIV community who are 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 chances of finding a suitable match and living a long life,” he said.
