On October 27, 2026, UC Davis Health announced its first kidney transplant from a deceased donor with HIV to a recipient living with HIV. It is a first for UC Davis and the Sacramento region, not for the country, but it shows how much has changed. Just over a decade ago, federal law did not allow organs from donors with HIV to be used for anyone, including people who were also living with HIV. Here is what changed, what the research shows, and what it means for people living with HIV and the people who love them.

What UC Davis Health announced

According to the UC Davis Health news release, the UC Davis Transplant Center launched an HIV-to-HIV kidney transplant program after federal rules changed in 2024. It is the only program of its kind in the Sacramento region. The first recipient had spent years on dialysis. After he agreed to accept a kidney from a donor with HIV, a suitable kidney became available within a few weeks of his waitlist activation, the release says.

"HIV-to-HIV transplantation creates an additional pathway to care because organs from donors with HIV are available only to recipients living with HIV," said Sana J. Shaikh, who oversees the program. "By increasing the number of organs available to these patients, we can potentially reduce wait times and help people get transplanted faster."

How the rules changed: from a ban to the HOPE Act

• Before 2013: Federal law prohibited using organs from donors with HIV in any transplant recipient, UC Davis Health notes.
• 2013: The HIV Organ Policy Equity (HOPE) Act, enacted November 21, 2013, allowed research on transplanting organs from donors with HIV into people already living with HIV, according to the Health Resources and Services Administration (HRSA).
• November 27, 2024: The U.S. Department of Health and Human Services (HHS) published a final rule removing the clinical research and institutional review board requirements for kidney and liver transplants from donors with HIV to recipients with HIV.
• June 26, 2025: Updated national transplant network (OPTN) policies took effect. HRSA says kidney and liver programs no longer have to run these transplants as research studies.

Transplants of other organs from donors with HIV, such as hearts or lungs, still must follow research rules, according to HRSA's HOPE Act page. HRSA reports that more than 500 HOPE Act transplants have been performed since 2013, "with no patient safety issues reported." HRSA also notes the updated policies use "more respectful and stigma-reducing" language about people, donors and recipients with HIV.

What the research shows

The 2024 rule followed a large study published in the New England Journal of Medicine in October 2024. The HOPE in Action study, funded by the National Institute of Allergy and Infectious Diseases, followed people with HIV at 26 U.S. centers who received a kidney from a deceased donor. Of 198 recipients, 99 got a kidney from a donor with HIV and 99 from a donor without HIV.

• Overall safety: On a combined safety measure (death, loss of the new kidney, serious adverse events, HIV breakthrough, persistent HIV treatment failure or opportunistic infection), kidneys from donors with HIV were noninferior to kidneys from donors without HIV.
• Survival: 94% vs 95% were alive at 1 year, and 85% vs 87% at 3 years.
• Kidney survival: 84% vs 81% were alive without losing the new kidney at 3 years.
• Rejection, infections and cancer: Similar in both groups.
• One difference: HIV breakthrough infections were more common in people who received kidneys from donors with HIV. Among the 58 recipients in that group with sequence data, there was one potential HIV superinfection, and there were no persistent HIV treatment failures.

This was an observational study, not a randomized trial. Its authors concluded that transplantation from donors with HIV "appeared to be noninferior" to transplantation from donors without HIV.

Why this matters for people living with HIV

"Many people living with HIV develop kidney disease over the course of their lives, and some will require a transplant," Shaikh said in the release. UC Davis Health, citing HRSA data, says more than 95,000 people are on the U.S. kidney transplant waitlist, and most wait three to five years for a deceased-donor kidney, with longer waits in high-demand areas such as California.

Because kidneys from donors with HIV go only to recipients living with HIV, they add to the pool of organs for this group. "HIV is no longer a barrier to transplantation," said Alan Koff, a UC Davis Health infectious disease specialist in the program.

Kidney health is part of the bigger picture of living well with HIV over the long term. For more on recent changes in HIV care, see our coverage of updated U.S. HIV guidelines and our look at HPV cancer risk in people who are immunocompromised.

Can people with HIV be organ donors?

Yes. According to the National Institutes of Health (NIH), people with HIV have been able to donate organs in the United States since the 2013 HOPE Act, and those organs can only go to recipients who also have HIV. NIH notes that some people with HIV and certain other infections may not be eligible, and that donors with HIV are screened for HIV drug resistance so treatment keeps working for the recipient.

"Many people living with HIV are unaware that they can be organ donors," Koff said. Whether to stay registered as a donor is a question that comes up often in online HIV communities. Under the HOPE Act framework, being HIV-positive by itself does not rule someone out; medical teams evaluate each potential donor, as NIH describes.

Living donation is possible too. HRSA says living kidney or liver donation from a person with HIV to a recipient with HIV no longer requires a research protocol, but living donors with HIV must be told that the long-term effects of donating while living with HIV are unknown.

What it means for dating and relationships

• Stigma keeps shrinking. Policy that once treated HIV as a reason to throw away a lifesaving organ now treats people with HIV as both donors and recipients. Our guide to why HIV stigma still exists explores what else needs to change.
• Health talks are part of real relationships. If you or a partner is living with kidney disease, dialysis or a transplant wait, it's okay to share that on your own timeline, just as with HIV status. Disclosure expectations and legal duties differ by state. Our guide on how to tell someone you have HIV may help.
• U=U still applies. CDC says people with HIV who take treatment as prescribed and keep an undetectable viral load will not transmit HIV to sexual partners. See our U=U explainer.
• Questions belong with a clinician. Whether a transplant, organ donation or living donation fits your situation is a decision for you and a transplant team or HIV care provider. Community can help too: see our list of online HIV support groups.
• Dating safely still matters. When you meet someone new, meet in a public place, verify who they are, and make sure every step is consensual.

Quick FAQ

Can someone without HIV receive a kidney from a donor with HIV?
No. NIH and UC Davis Health say organs from donors with HIV are available only to recipients living with HIV.

Do people with HIV on the waitlist have to accept an organ from a donor with HIV?
No. HRSA says the transplant system defaults to "No," and a transplant physician must document that a candidate is living with HIV and willing to accept an organ from a donor with HIV. Consent is confirmed again before the transplant.

Does this apply to hearts, lungs or other organs?
Not yet in routine care. Only kidney and liver transplants left the research-only requirement; other organs from donors with HIV still require research protocols, according to HRSA.

Was this the first HIV-to-HIV transplant in the U.S.?
No. It was UC Davis Health's first. HRSA counts more than 500 HOPE Act transplants nationwide since 2013.

The bottom line

UC Davis Health's first HIV-to-HIV kidney transplant is one more sign that HIV is no longer the barrier it once was, in medicine and in law. For people living with HIV who need a kidney, organs from donors with HIV can add options, and research so far shows outcomes similar to kidneys from donors without HIV. If you're looking for people who understand life with HIV, explore STD dating on MeetPositives.

Sources

• UC Davis Health. "UC Davis Health performs first HIV-to-HIV kidney transplant." News release, October 27, 2026.
• Durand CM, Massie A, Florman S, et al.; HOPE in Action Investigators. Safety of Kidney Transplantation from Donors with HIV. N Engl J Med. 2024;391(15):1390-1401. doi:10.1056/NEJMoa2403733.
• HHS. Organ Procurement and Transplantation: Implementation of the HIV Organ Policy Equity (HOPE) Act. Final rule, 89 FR 93484, November 27, 2024.
• HRSA, Organ Procurement and Transplantation Network. "HOPE Act" (last reviewed May 2026).
• NIH HIVinfo. "HIV and Transplant" fact sheet (last reviewed April 9, 2025).
• CDC. "HIV Treatment as Prevention" (cdc.gov).

This article is for general information only and is not medical or legal advice. It does not create a doctor-patient relationship. Talk with a licensed health care provider about your own situation. Laws vary by state; for legal questions, talk with a licensed attorney.