Doctors Perform World’s First HIV-Positive to HIV-Positive Heart Transplant

HIV patients now have a second chance at life thanks to the HIV Organ Policy Equity (HOPE) Act, which called for the development and publication of research criteria relating to transplantation of HIV positive organs into HIV positive individuals. 

When the United Network for Organ Sharing announced that HIV-positive patients are eligible to receive organ transplants, John Hopkins became the first hospital in the United States to perform HIV-positive to HIV-positive organ transplants. It went on to become the first in the world to execute an HIV-positive to HIV-positive liver transplant and the first in the United States to do an HIV-positive to HIV-positive kidney transplant.

And now doctors at Montefiore Health System in New York City have completed the world’s first HIV-positive to HIV-positive heart transplant.

“The goal of the Montefiore heart transplant team is to constantly push and establish new standards so that anyone who is appropriate for an organ transplant can benefit from this life-saving procedure,” said Daniel Goldstein, M.D., professor and Vice Chair, Department of Cardiothoracic Surgery and Surgical Director.

The patient was in her sixties and had suffered from advanced heart failure. She also received a new kidney in the spring. It took nearly a decade for doctors to accomplish such a feat after the HIV Organ Policy Equity Act was passed in 2013.

HIV patients must have an undetectable viral load and a CD4 count over 200 to be considered for a transplant.

Montefiore is one of only 25 centers in the country that can perform this kind of surgery, having met prior surgical benchmarks and outcomes set by the Organ Procurement and Transplantation Network.

“Thanks to significant medical advances, people living with HIV are able to control the disease so well that they can now save the lives of other people living with this condition,” said Dr. Ulrich P. Jorde, Section Head – Heart Failure, Cardiac Transplantation & Mechanical Circulatory Support, and Vice Chief, Division of Cardiology at Montefiore and Professor of Medicine at Einstein.

Experts say recent advances in HIV treatment and organ transplantation will increase the number of people who can donate.

There are between 60,000 and 100,000 people in the U.S. currently waiting for a new heart, however only around 3,800 transplants were performed in 2021.

“This was a complicated case and a true multidisciplinary effort by cardiology, surgery, nephrology, infectious disease, critical care and immunology,” said Dr. Omar Saeed, the patient’s cardiologist. “Making this option available to people living with HIV expands the pool of donors and means more people, with or without HIV, will have quicker access to a lifesaving organ. To say we are proud of what this means for our patients and the medical community at large, is an understatement.”

For decades, patients living with HIV were ineligible for organ transplants. Without access to donor organs, a serious disease or diagnosis could result in a death sentence.

An old law prevented doctors from giving organs to HIV-positive patients, but the HOPE Act reversed this rule. Studies show positive outcomes for HIV-positive patients that received HIV-negative organs.

“Organ transplantation is critical for patients with HIV, who die on the waiting list even faster than their HIV-negative counterparts,” says Dorry L. Segev, M.D., Ph.D., professor of surgery at the Johns Hopkins University School of Medicine. “We are very thankful to Congress, the president and the entire transplant community for letting us use organs from HIV-positive patients to save lives instead of throwing them away, as we had to do for so many years.”