Cedars-Sinai's New HIV Transplant Program Is First Of Its Kind In LA Area

LOS ANGELES, CA — Cedars-Sinai has performed its first kidney and liver transplants using organs from deceased donors with HIV for recipients who also have HIV, a practice that can significantly shorten the wait for a lifesaving organ.

The procedures were performed through the Cedars-Sinai Comprehensive Transplant Center's new HIV-to-HIV transplant program, which the hospital says is the only program of its kind in the Los Angeles area, according to the hospital.

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One kidney recipient had been on the transplant waitlist for more than two years and was not expected to receive an organ offer soon. After joining the list for HIV-positive donor organs, the patient received an offer in less than a week.

That patient and Cedars-Sinai's first HIV-positive liver recipient are doing well following their transplants, hospital officials said.

"We brought together a team of liver and kidney transplant surgeons, nephrologists, hepatologists, transplant pharmacists, infectious disease experts, transplant coordinators and more to launch this program," said Dr. Tsuyoshi Todo, the transplant surgeon who led both procedures.

Federal law once prohibited organs from donors with HIV from being transplanted into any patient, including recipients with HIV.

That changed with the 2013 HIV Organ Policy Equity Act, known as the HOPE Act, which allowed researchers to study HIV-to-HIV transplants. Federal rules were changed again in 2024 to remove strict research requirements after studies documented the safety and effectiveness of the procedures.

Advances in antiretroviral treatment have also allowed people with HIV to live longer, increasing the number who may eventually develop kidney, liver or other organ failure.

"The vast majority of patients we see living with HIV have their disease well controlled, often with only one pill a day and minimal side effects," said Dr. Christopher Foltz, the program's lead infectious disease specialist.

Foltz evaluates potential transplant recipients before surgery and helps determine whether their HIV medications need to change when they begin taking immunosuppressant drugs after a transplant. Patients are also monitored closely for changes in their HIV viral load, particularly during the first six months after surgery, Foltz said.

The program could also help some patients avoid years on transplant waiting lists.

More than 95,000 people are on the kidney transplant waiting list nationwide, according to the Health Resources & Services Administration. Cedars-Sinai officials said patients in Southern California can face waits of eight to 10 years for a kidney.

"For HIV-positive patients, being listed on a separate list for HIV-positive donor organs can drastically reduce their wait," Todo said.

The option can be especially important for people with liver failure, because there is no dialysis-like treatment that can keep them alive while they wait for an organ. Patients are generally prioritized for liver transplants based on the severity of their illness.