Montefiore Einstein Successfully Performs the World’s First HIV-Positive to HIV-Positive Heart Transplant

The world’s first HIV-positive to HIV-positive heart transplant has been successfully performed at Montefiore Einstein. The patient, in her sixties, suffered from advanced heart failure and received the life-saving donation, along with a simultaneous kidney transplant, in early spring. After the four-hour surgery, she spent five weeks recovering in the hospital and now sees her transplant physicians at Montefiore Einstein for monitoring.

Montefiore Einstein is one of only 25 centers in the United States eligible to offer this complex surgery, having met prior surgical benchmarks and outcomes set by the Organ Procurement and Transplantation Network.

“Previously unthinkable, this is a significant milestone not just for people living with HIV who have been able to receive organs from others but were prohibited from donating, but for all patients awaiting heart transplantation,” said Ulrich P. Jorde, MD, Head of Heart Failure, Cardiac Transplantation & Mechanical Circulatory Support, Vice Chief, Division of Cardiology at Montefiore, and Professor of Medicine at Albert Einstein College of Medicine. “Going forward, those patients on the list who are HIV-positive may now, at highly select centers such as Montefiore Einstein, receive HIV-positive organs. This will not only reduce their own wait time, but reduce the number of patients on the wait list, thus allowing earlier access to an organ for others.”

Montefiore Einstein’s heart transplantation team is internationally renowned for spearheading innovative methods, like transplanting a heart from a donor who died after their heart had stopped beating—a novel approach that has the potential to save hundreds more people in need of a new heart each year.

“The goal of the Montefiore Einstein 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 lifesaving procedure,” said Daniel Goldstein, MD, Professor and Vice Chair, Department of Cardiothoracic Surgery, and Surgical Director, Cardiothoracic & Vascular Surgery and Cardiac Transplantation & Mechanical Assistance Programs, Montefiore and Albert Einstein College of Medicine.

This transformative surgery occurs almost a decade after the passage of the HIV Organ Policy Equity Act, which enabled people living with HIV to donate their organs to a HIV-positive recipient, but it has taken almost 10 years for this opportunity to become a reality for heart transplantation. “The heart transplant procedure itself did not pose any unusual challenges, I was, however, delighted to complete a history making surgery that would open the door to benefiting HIV-positive patients on the heart transplant waiting list,” says cardiac surgeon Jamil Borgi, MD, who performed the operation.

Although there are between 60,000 and 100,000 people who could benefit from a new heart in the United States, 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 the patient’s cardiologist, Omar Saeed, MD, Attending Physician and Assistant Professor of Medicine, Montefiore Einstein. “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.”