First HIV-Positive Living Donor Liver Transplant at Johns Hopkins

This story matters to me because it shows exactly what happens when policy catches up with science. In March 2019, surgeons at Johns Hopkins Medicine performed a medical first: a living-donor liver transplant from an HIV-positive donor to an HIV-positive recipient. The surgery, led by Dr. Dorry Segev, was made possible by the HOPE Act (HIV Organ Policy Equity Act) of 2013, which had finally allowed organs from HIV-positive deceased donors to be transplanted into HIV-positive recipients. This case extended that principle to living donors. A policy change made this surgery possible. That's not a coincidence — that's how it works.

The HOPE Act

Before the HOPE Act, it was illegal in the United States to use organs from HIV-positive donors, even for HIV-positive recipients. Think about that: perfectly viable organs were being thrown away because of a policy default. HIV-positive patients who died were unable to donate their organs, and HIV-positive patients on the waitlist competed for the same limited pool as everyone else. The HOPE Act changed the default, and Johns Hopkins was the first institution to act on it.

"This represents a new frontier in transplantation. For the first time, people living with HIV can save each other's lives through living donation." — Dr. Dorry Segev, Johns Hopkins University School of Medicine

The Donor's Story

The anonymous donor, a woman living with well-controlled HIV, chose to donate a portion of her liver to a recipient also living with HIV. Both individuals were on modern antiretroviral therapy that suppressed their viral loads to undetectable levels. The surgery was successful, and both donor and recipient recovered well. The donor later spoke publicly about her motivation: she wanted to prove that people with HIV could give back and save lives.

Expanding the Donor Pool

This transplant has significant implications for the donor pool. There are over one million people living with HIV in the United States. If even a fraction become organ donors — either as living donors or deceased donors — the impact on the waiting list could be substantial. Johns Hopkins estimates that HIV-positive donors could provide up to 500 additional organs per year for HIV-positive recipients.

"This is about equity. People with HIV deserve the same opportunity to save lives that anyone else has." — Johns Hopkins transplant program

Why YCOD Cares

This is exactly the kind of story that fuels what we do at YCOD. A bad policy was keeping viable organs from reaching people who needed them. Someone changed the policy. Lives were saved. It's the same principle behind everything we fight for: changing the default saves lives. Breaking down barriers and stigma around who can donate is just as important as changing the default from opt-in to opt-out through Bill A07954. The system, not individuals, is what we need to fix — and the HOPE Act proved it can be done.