For 26 years, Bertrand Nelson’s body was a battleground. He fought HIV and sarcoidosis. Then, a devastating bout of Legionnaires’ disease in 2021 left his lungs shattered and his liver failing. By 2024, the 56-year-old was tethered to an oxygen tank. 

He needed a miracle. On March 21, 2026, he got two and made medical history.

In a marathon surgery at NYU Langone Health, surgeons performed the world’s first HIV-positive-to-HIV-positive lung transplant. Nelson did not just get a new lease on life. He also received a new liver on the exact same day. Today, he is breathing entirely on his own.

“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. 

“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,” Mehta added.

Expanded donor pool

Organs from HIV-positive donors were strictly discarded. However, the 2013 HIV Organ Policy Equity (HOPE) Act opened the door for research protocols to change that. While doctors have previously transplanted HOPE hearts, kidneys, and livers, the delicate and infection-prone nature of lungs kept them off the table until now. 

The breakthrough addresses a deep inequity in the American healthcare system. Right now, roughly 1.2 million people in the U.S. live with HIV. Because of modern antiretroviral therapies (ART), most live near-normal lifespans and cannot transmit the virus. 

Under the old rules, organ failure meant facing an excruciatingly long waitlist. By allowing HIV-positive patients to accept organs from HIV-positive donors, medicine is unlocking an entirely new pool of available lifelines. 

“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. 

Nelson was ready to be that patient. His motivation was close to home.

“I want to be well for her,” Nelson said, speaking of his mother, who turns 82 this August. “I want her to see me thriving.”

Nelson is doing fine now

In 2000, Nelson was diagnosed with HIV and sarcoidosis, a condition that went into remission until a severe case of Legionnaires’ disease in 2021 reactivated it, damaging both his lungs and liver. 

By 2024, his health had deteriorated to the point of requiring continuous oxygen, leading to his evaluation for a groundbreaking dual-organ transplant under the HOPE Act. On March 21, the medical history was made with the first HIV-positive-to-HIV-positive lung transplant. 

Nelson is currently out of the hospital, lifting weights, and rebuilding the strength he lost during four grueling years of limited mobility.

For the broader medical community, NYU Langone’s triumph is a proof of concept. The institute is currently one of the only centers in the nation approved to perform these specific transplants. But Nelson hopes his story will spark a chain reaction, raising awareness and expanding the protocol to hospitals nationwide.

“There are so many others who need access to this level of care,” Nelson said. “The more organs that become available, the better the odds of finding the right match and living a long life.”

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