First transplant between two people with HIV in the State

BarcelonaThe first transplant between two people with HIV in Spain ends a prohibition that had been in place for almost forty years. Since 1987, people with the virus could receive organs from HIV-negative donors, but they could not become donors, not even for other people with the same infection. This limitation was repealed in 2025 thanks to a new protocol promoted by the National Transplant Organization (ONT), which authorizes these interventions as long as both the donor and recipient meet very strict clinical criteria, such as maintaining an undetectable viral load and not having suffered from certain opportunistic infections.

The Vall d'Hebron University Hospital in Barcelona has been the center where this pioneering intervention has been carried out: a living donor kidney transplant between two middle-aged men that has been possible thanks to good infection control with antiretroviral treatments.

The recipient suffered from chronic glomerulonephritis, a non-HIV-related kidney disease that had progressed to require a transplant. The intervention was performed using robotic surgery and, as the hospital reported this Friday, it represents a milestone both from a medical point of view and in terms of the rights of patients with HIV, who since 2025 can be organ donors under the same conditions as the rest of the population.

"Vall d'Hebron once again places itself at the forefront: in 1981 we were the first hospital in the State to diagnose a patient with HIV, and now, forty-five years later, we have performed the first transplant between two people with the virus," states the center's manager, Albert Salazar.

The possibility of these transplants is a direct consequence of the transformation that HIV has undergone in recent decades. The advent of antiretroviral therapy has turned a previously fatal disease into a controllable chronic infection, with a life expectancy increasingly similar to that of the general population. This means that many people with HIV develop the same pathologies as the rest of the population, including kidney, liver, or heart failure that may eventually require a transplant.

According to data from the organization, each year about fifty people with HIV are waiting for a transplant in Spain: thirty need a kidney, fifteen a liver, and the rest a heart, lung, or pancreas. The coordinator of donation and transplants at Vall d'Hebron, Albert Sandiumenge, believes this change "will help reduce the waiting time" for these patients.

International experience supports this practice. The first transplant between two people with HIV was performed in South Africa in 2008 and, since then, various studies have shown that the results are comparable to those of other recipients, without an increase in virological failures or opportunistic infections. The United States began authorizing them in 2013 in clinical trials, and since 2024, kidney and liver transplants have been part of routine clinical practice. In Europe, they are also permitted in countries such as Italy, France, the United Kingdom, and, since last year, Spain.