The HIV-positive patient who received Cedars-Sinai’s first HIV-positive donor kidney had previously been listed on the waitlist for more than two years and was not expected to receive an organ offer in the near future. Once listed on the HIV-positive organ list, the patient received an organ offer in less than a week.

This patient and the first HIV-positive liver recipient are doing well following their transplants, which were made possible by the Comprehensive Transplant Center’s new HIV-to-HIV transplant program, currently the only-of-its-kind in the Los Angeles area.

“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 transplant surgeon Tsuyoshi Todo, MD, who served as the lead surgeon on both the first HIV-to-HIV-positive kidney and HIV-to-HIV-positive liver transplant at Cedars-Sinai.

New HOPE for Transplant Recipients

Cedars-Sinai’s HIV-to-HIV transplant program represents a dramatic shift from just over a decade ago, when federal law prohibited organs from donors with HIV from being transplanted into any patient, including those where were also HIV-positive.

That changed in 2013 with the passage of the HIV Organ Policy Equity (HOPE) Act, which allowed clinical researchers to study HIV-to-HIV transplants. After years of research documented the safety and effectiveness of HIV-to-HIV transplants, the rule was amended in 2024, removing the strict research requirements, and Cedars-Sinai quickly formed a multidisciplinary committee of experts to bring the institution’s HIV-to-HIV program to life.

“Everyone has an important role to play to help patients through this process,” Todo said.

Support for HIV-Positive Patients

Thanks to advances in antiretroviral therapy, people with HIV are living significantly longer and healthier lives, which opens the chance they experience end organ failure due to other comorbidities.

“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 Christopher Foltz, MD, lead infectious disease specialist for the HIV-to-HIV transplant program at Cedars-Sinai. “In a sense, it’s almost become easier to manage HIV than it is other chronic conditions like hypertension and diabetes.”

Foltz connects with every potential HIV-positive organ recipient as a pre-evaluation to ensure their HIV is managed and, working with Cedars-Sinai pharmacists, determines whether there are any changes that will need to be made to their HIV medication regimen once they are also taking post-transplant immunosuppressant drugs. He also closely follows each patient after their transplant to monitor their HIV viral load and ensure it remains undetectable.

“The first six months post-transplant is when the immune system is being hit the hardest,” Foltz said. “We will monitor the patient’s HIV closely during this time, but eventually, they’ll be able to get back to monitoring once or twice a year, like they would have been doing before.”

Foltz hopes this program encourages more people to register as organ donors as well.

“If you were to ask most people living with HIV, they probably would assume they’re not eligible to be an organ donor, but that is no longer the case,” Foltz said. “Organ donations are lifesaving, and I think it can be really uplifting to them to know they can support others in their community in this way.”

Reduced Wait Times

More than 95,000 patients are on the kidney transplant waitlist, according to data from the Health Resources & Services Administration (HRSA). Most people will wait three to five years for a deceased donor kidney, but that time frame can significantly increase in densely populated areas with a higher demand.

“In Southern California, many patients are actually looking at eight to 10 years on the transplant waitlist, but for HIV-positive patients, being listed on a separate list for HIV-positive donor organs can drastically reduce their wait,” Todo said. “This translates to several years that these patients will not have to be on dialysis, not only getting them back to their normal life more quickly, but also saving hundreds of thousands of taxpayer dollars.”

While patients with kidney failure can live many years on dialysis, there is no similar treatment for patients with liver failure. These patients are listed on the transplant waitlist based on their Model for End-Stage Liver Disease (MELD) score, a number from six to 40 that predicts a patient’s risk of death from liver failure in three months.

“Patients in the Los Angeles area will typically need to have a MELD score in the low 30s in order to receive a transplant, but by accepting an HIV-positive organ that would have otherwise gone to waste, our HIV-positive patient was able to be transplanted with a much lower score,” Todo said. “In the standard circumstance, they would have had to wait significantly longer and get much sicker before receiving an organ.”

Looking Toward the Future

With the first few HIV-to-HIV transplants successfully completed, the team looks forward to making this option available to more HIV-positive patients moving forward.

“At Cedars-Sinai, we strive to be on the leading edge of medical innovation to provide outstanding patient care and support to as many patients as possible, and our HIV-to-HIV transplant program is an example of that effort,” said Irene Kim, MD, director of the Cedars-Sinai Comprehensive Transplant Center. “To be able to transplant more individuals and help them live longer, healthier lives is an honor.”

Read more from Cedars-Sinai Stories and Insights—Being Patient: The Delicate Timing of Organ Transplantation

Irene Kim, MD, director of the Cedars-Sinai Comprehensive Transplant Center, partially credits the increase in liver transplants to the use of machine perfusion, a technology that circulates oxygen-rich, nutrient-rich, blood-based solution through donor organs until transplantation. Machine perfusion reduces graft dysfunction, allowing organs to be viable longer and improving physicians’ assessments of the organs ahead of transplantation—all of which has served to increase donor organ availability, Kim said.

A willingness to take on the most complex cases also helped drive the increase in lung transplants, according to Kim, as Cedars-Sinai is known for accepting high-risk cases that had been previously turned away by other institutions.

“We are committed to staying on the leading edge of transplant technology to ensure the best results for our patients, with survival outcomes that continue to meet or exceed the national average,” Kim said. “The more organs we can transplant, the more patients can receive a second chance at life. It’s a privilege to not only help these patients, but also to honor the donors who gave the ultimate gift of life.”

According to published data from the Organ Procurement and Transplantation Network (OPTN), 49,065 transplants occurred in the U.S. in 2025—more than in any other year. With records continuing to be set year over year, the OPTN has set an ambitious nationwide goal of 60,000 deceased donor transplants annually by the end of 2026.

New Records in Liver and Lung Transplants, Living Kidney Donors

The Department of Cardiac Surgery in the Smidt Heart Institute is the largest heart transplant center by volume in California, with clinical and surgical teams performing 114 adult heart transplants in 2025. The team, led by Joanna Chikwe, MD, chair of the Department of Cardiac Surgery, Fardad Esmailian, MD, surgical director of the Heart Transplant Program, and Jon Kobashigawa, MD, director of the Heart Transplant Program in the Department of Cardiology, has maintained an average of more than 100 heart transplants each year for the last 13 years, a current record in the U.S.

Surgical Director Dominick Megna, MD, and Medical Director Reinaldo Rampolla, MD, led the lung transplant team to perform 93 lung transplants in 2025—the most ever at Cedars-Sinai—surpassing its previous record of 88 in 2024. The Lung Transplant Program in the Smidt Heart Institute at Cedars-Sinai continues to be the largest by volume in California and, in 2025, earned a place as a top 10 center by volume in the U.S.

The Liver Transplant Program also reached new milestones. The team, led by Kim, as surgical director, and Alexander Kuo, MD, professor of Medicine and medical director of the Liver Transplant Program, performed 145 liver transplants in 2025, exceeding the 2024 record of 136 transplants.

The Kidney Transplant Program team, led by Stanley Jordan, MD, medical director of the Comprehensive Transplant Center’s Human Leukocyte Antigen and Transplant Immunology Laboratory, and Tsuyoshi Todo, MD, surgical director, completed 324 transplants in 2025, including one pancreas-kidney transplant.

Notably, the team performed 80 living donor kidney transplants in 2025, setting a record for the number of living donor kidney transplants performed at Cedars-Sinai, with a more than 15% increase over the previously held record volume of 69 in 2013. This program, led by Steven Wisel, MD, and Reiad Najjar, MD, has transformed into a completely robotic surgical program.

“These achievements are a testament to the hardworking team at the Cedars-Sinai Comprehensive Transplant Center,” said Kim, the Esther and Mark Schulman Chair in Surgery and Transplantation Medicine. “But none of these lifesaving procedures would be possible without the altruism of organ donors and their families. We are tremendously grateful to those who give the gift of life through organ donation.”

Read more from Cedars-Sinai Stories and Insights: After Lung Transplant, a Return to Running

Cedars-Sinai is among the top 10 transplant centers in the U.S. by volume, according to published data from the Organ Procurement and Transplantation Network (OPTN), and is known for accepting complex, high-risk cases.

“Behind every transplant is a patient who desperately waited for a chance at life,” said Irene Kim, MD, director of the Cedars-Sinai Comprehensive Transplant Center. “It is the remarkable generosity of organ donors and their families that allowed our transplant teams to give 682 patients the chance to have longer and healthier lives.”

Cedars-Sinai’s organ transplant program has experienced a 64% year-over-year increase since 2017, when 415 transplants were performed. Over the last decade, its transplant volume has increased by 84%, from 371 in 2014 to 682 in 2024.

Multiple drivers are behind the upward trend in organ transplants at Cedars-Sinai and nationwide, said Kim, the Esther and Mark Schulman Chair in Surgery and Transplantation Medicine.

“Machine perfusion techniques are allowing us to use donor organs that may previously have been less ideal for transplant,” Kim said. “The technology helps preserve organs before transplantation, lengthening viability, improving assessment of organ function and contributing to improved patient outcomes.”

According to the OPTN, 48,149 transplants occurred in the U.S. in 2024—more than in any other year.

But the need for more organs remains significant: More than 100,000 people in the U.S. are on the organ transplant waiting list, according to the United Network for Organ Sharing, the nonprofit organization that manages the U.S. organ transplant system.

Multiple collaborations among various sectors are underway to increase organ donations in an effort to reach a new national goal: 60,000 deceased donor transplants annually in the U.S. by the end of 2026.  

New Records in Heart, Liver and Lung Transplants

The Department of Cardiac Surgery in the Smidt Heart Institute at Cedars-Sinai is home to the largest thoracic organ transplant program by volume in California and the second-largest heart transplant center by volume in the U.S. 

The team, including Joanna Chikwe, MD, chair of the Department of Cardiac Surgery, Fardad Esmailian, MD, surgical director of the Heart Transplant Program, and Jon Kobashigawa, MD, director of the Heart Transplant Program in the Department of Cardiology, led the clinical and surgical teams that performed 137 adult heart transplants, including three heart-lung transplants, surpassing the 2023 record of 132. 

The lung transplant team, led by surgical director Dominick Megna, MD, and medical director Reinaldo Rampolla, MD, also reached a new milestone in 2024 with 88 lungs transplanted (including three heart-lung transplants), up from 82 in 2023. More than a quarter were completed using minimally invasive procedures—2- to 3-inch incisions that lead to reduced pain, recovery times and complications after surgery. Nine percent of minimally invasive lung transplant surgeries at Cedars-Sinai—more than that of any other program in the world—were robotic-assisted.

The liver transplant team, led by Kim, surgical director of the Liver Transplant Program, and Alexander Kuo, MD, professor of Medicine and medical director of the Liver Transplant Program, performed 136 liver transplants in 2024, exceeding the 2021 record of 113 transplants.

The Kidney Transplant Program team, led by Stanley Jordan, MD, medical director of the Comprehensive Transplant Center’s Human Leukocyte Antigen and Transplant Immunology Laboratory, and Tsuyoshi Todo, MD, surgical director, completed 324 transplants in 2024, including five pancreas-kidney transplants. In 2023, the program set a record with 336 kidney transplants performed.

Kim emphasized that the expertise and dedication of Cedars-Sinai’s multidisciplinary transplant teams—physicians, nurses, social workers, pharmacists, physician assistants, dietitians, technicians, perfusionists, researchers, administrative professionals and others—are what enable transplants for so many patients.

“They are the ultimate caregivers,” Kim said. “And it is the organ donors and their families who represent ultimate altruism. They are the foundation that gives others an opportunity at life.”

Read more on the Cedars-Sinai Blog: The Wait for a New Heart

“I’ve always said, we’re like one coat of paint,” Thomas said. “Even our parents often couldn’t tell who was who when talking to us on the phone.”

Now, the sisters share more than just their DNA—they share a kidney. They also share an uncommon transplant experience, said Irene Kim, MD, the Esther and Mark Schulman Chair in Surgery and Transplantation Medicine and director of the Cedars-Sinai Comprehensive Transplant Center.

“It’s a rare event to transplant a patient with a genetically identical organ because it requires having an identical twin,” Kim said. “This is only the second time in my career that this has happened.”

The twins’ transplant story began in October 2021, when Thomas was diagnosed with multiple myeloma, a rare blood cancer that affects plasma cells. The disease caused her to go into kidney failure and damaged the C1 vertebra in her spine, putting her in a neck brace for more than six months. The next few years included a litany of medical procedures for Thomas, including chemotherapy, neck surgery and even a bone marrow transplant. Her twin was by her side every step of the way.

While Thomas’ cancer is now in remission, her kidney function never returned to normal. A transplant was the next step to keep her from requiring IV fluids or dialysis for the rest of her life. Rodman didn’t hesitate to volunteer to donate one of her own kidneys.

“We never even had to have a conversation about it,” Rodman said. “I knew I couldn’t go on with my life with my sister not being able to have a better quality of life. It was just the right thing to do.”

There were concerns, however, that the immunosuppressant medications typically required for transplant patients to keep their body from rejecting a transplanted organ could cause a recurrence of Thomas’ multiple myeloma. But through testing, Thomas and Rodman learned they were a match across all markers and were more than 99% identical, meaning Thomas could avoid the antirejection drugs that could have caused her cancer to return.  

“Transplantation requires immunosuppression to trick our immune systems into believing that the organ we’re transplanting is not foreign so that our body’s natural immune defense doesn’t attack or reject it, and that immunosuppression can have a lot of side effects of its own,” Kim said. “That we can avoid immunosuppression altogether for Linda by transplanting a kidney that is genetically identical to hers is really exciting and remarkable.”

Kim explained this is an uncommon occurrence in the transplant world not only because demographically, there are just fewer identical twins, but also because doctors must consider the reason a transplant is required. If a transplant is necessary due to a genetic predisposition for kidney disease, giving up a kidney could put the donor at risk down the line. In Thomas’ case, her multiple myeloma was nongenetic.

“Living donor transplants are always an emotional event filled with stress and gratitude, but the bond Linda and Karen share as identical twin sisters is palpable,” Kim said. “It was just such an honor from a transplant surgeon’s perspective to be part of that.”

The pair underwent successful kidney donation and transplant procedures at Cedars-Sinai Medical Center in mid-October. The transplanted kidney began working immediately and Thomas was able to have her dialysis port removed shortly after surgery because it was no longer needed.

Thomas and Rodman spent the remainder of the month and most of November recovering together in Los Angeles so they could be close to the hospital for their many follow-up appointments. As they regained their strength following surgery, they often would spend afternoons visiting local beaches to walk together on the sand.

“The beach is our happy place,” Rodman said.

“I’m just so grateful to have been able to go through this with my sister. If it had been the other way around, it would have absolutely been the same,” Thomas said. “I would do anything for my sister.”

As they look to the future, they’re excited for more big milestones with their families. Rodman recently learned she’ll be a first-time grandmother next spring. They also look forward to more camping trips to the beach and the opportunity to travel.

“We’re only 56 years old,” Rodman said. “We have places to go. We have things to do. We have more life to live.”

Read more from Cedars-Sinai Discoveries Magazine—OR Talk: Triple Organ Transplant

Known for leading-edge therapies and taking on the most complex patients, Cedars-Sinai transplant teams also completed a triple organ transplant in 2023, performing a successful heart, liver and kidney transplant during a 20-hour surgery.

“Genuine compassion, commitment and teamwork enable us to perform these lifesaving operations,” said Irene Kim, MD, the Esther and Mark Schulman Chair in Surgery and Transplantation Medicine and director of the Cedars-Sinai Comprehensive Transplant Center. “We are so fortunate to be able to offer our patients lifesaving treatments through donors’ gifts of life.”

There currently are more than 100,000 people in the U.S. on the organ transplant waiting list, according to the United Network for Organ Sharing, the nonprofit organization that manages the U.S. organ transplant system. About 20,000 of those are in California.

In 2023, Cedars-Sinai was the ninth-largest transplant center by volume in the U.S., according to current published data from the Organ Procurement & Transplantation Network.

The Comprehensive Transplant Center and Smidt Heart Institute reported excellent patient outcomes, with one-year survival after transplantation at 91% or greater and lung, liver and kidney survival exceeding the national average.

The Kidney Transplant Program team, led by Stanley Jordan, MD, medical director of the Comprehensive Transplant Center’s Human Leukocyte Antigen and Transplant Immunology Laboratory, demonstrated the largest leap. The team performed 336 kidney transplants in 2023, including 15 pediatric transplants. The previous record was 298.

The liver transplant team, led by Nicholas Nissen, MD, surgical director of the Liver Transplant Program and director of Hepatobiliary and Pancreatic Surgery, and Alexander Kuo, MD, professor of Medicine and medical director of the Liver Transplant Program, performed 104 liver transplants in 2023. The 2022 figure was 102.

The Department of Cardiac Surgery in the Smidt Heart Institute is home to one of the largest thoracic organ transplant programs in the U.S. Led by Jon Kobashigawa, MD, director of Advanced Heart Disease and the Heart Transplant Program in the Smidt Heart Institute, and Fardad Esmailian, MD, surgical director of the Heart Transplant Program, the team performed 130 adult heart transplants and two heart-lung transplants in 2023.

The lung transplant team, led by surgical director Dominick Megna, MD, and medical director Reinaldo Rampolla, MD, also reached a new milestone in 2023 with 80 lungs transplanted, placing the program among the top 10 of U.S. lung transplant programs.

The Cedars-Sinai multidisciplinary transplant teams include physicians, nurses, social workers, pharmacists, physician assistants, dietitians, technicians, perfusionists, researchers, administrative professionals and others committed to successful organ transplants.

“So many people work together to create these lifesaving programs, and the contributions of our donors, family and friends who support our transplant team are profound,” Kim said. “They step in to help our patients and their caregivers make it through a transplant, help each other when things get busy and offer our patients and team members emotional and physical support when needed. That is truly inspiring.” 

Read more on the Cedars-Sinai Blog: 7 Myths About Organ Donation

Kim, who holds the Esther and Mark Schulman Chair in Surgery and Transplantation Medicine at Cedars-Sinai, told “In Depth” host Hal Eisner that organ transplants help people get back to their normal lives.

“Solid organ transplant is usually the treatment of choice for an organ failure, and it gives patients their lives back,” Kim told Eisner. “I always tell patients, ‘Once you get out of the immediate post-operative period, we want you to enjoy your life. We want you to travel … and do all the things that you had intended to do before the transplant.’”

Kim told Eisner that more than 100,000 people in the U.S. are waiting for a solid organ transplant and that one single donor can save eight lives.

“I just want to acknowledge the incredible gift of life that organ donors provide,” Kim said. “I hope that more and more people who are interested in organ donation make their wishes known, either through their driver’s license or with their families.”

Kim also told Eisner about recent innovations in organ transplantation.

“At Cedars, we performed our first robotic lung transplant ever in the world, where we can do a lung transplant through these small incisions instead of the classic huge clamshell incision that we’ve had to do in the past,” she said.

Cedars-Sinai set a record for solid organ transplants in 2023, including its first successful triple transplant.

Click here to watch the complete interview on FOX 11. 

But today, Sams walks side by side with his son, Valance “Vee” Sams Jr. He’s exercising again, eating healthy, and focused on rebuilding his strength, thanks to a triple organ transplant at Cedars-Sinai.

“I’m feeling good, great, awesome,” he said. “It’s night and day.”

After a successful 20-hour surgery this spring, Sams is one of just 46 people in the U.S. to receive a heart, liver and kidney transplant since the United Network for Organ Sharing (UNOS), the government agency that tracks organ transplants, started tracking in 1987.

“Going through the UNOS database, I can see that prior to Mr. Sams, there were only 45 of these triple organ transplants,” said Tyler Gunn, MD, director of the Extracorporeal Membrane Oxygenation Program and Sams’ heart surgeon. “Since then, the average has been only about 1.5 of these surgeries per year in the U.S., more frequently within the last five years as providers and surgeons get more comfortable with the operations and technology.”

Sams’ journey began when the sarcoidosis diagnosis necessitated multiple visits each week to his doctors to monitor his condition, drain built-up fluids from his body, and administer dialysis treatments.

“If the heart's not working, it can cause something called congestive hepatopathy in the liver, where the liver just starts not to work very well, and can cause chronic and permanent damage of the liver, and then it can also cause stress on the kidneys as well,” said Irene Kim, MD, director of the Cedars-Sinai Comprehensive Transplant Center and the Esther and Mark Schulman Chair in Surgery and Transplantation Medicine.

In order to make it to all of his medical appointments and keep up with his health, Sams was forced to quit film school, a deeply devastating decision.

His son, Vee, then a teenager, took on the role of nurse, counting out medications and helping his father prepare meals that would keep his health on track.

“I was basically his personal nurse,” Sams Jr. said. “I made sure everything was OK, he wasn’t missing appointments. I made sure his medicines [were] OK, you know, changing his bags for dialysis at the house.”

Sams Sr. gets emotional when talking about how much of a help his son was.

“Since the beginning, he’s been like my nurse, my best friend, my brother,” Sams Sr. said.

Early this year, Sams Sr.’s health took a turn for the worse–he was hospitalized because, despite keeping up with his treatments, his heart, liver and kidneys were failing.

After a two-month hospital stay, Sams received news of a new hope–a matching heart, liver and kidney were available for transplantation.

Sams’ surgeons, Gunn, Nicholas Nissen, MD, and Justin Steggerda, MD, worked together with their teams of up to 15 other providers at a time, in a 20-hour-long operation to transplant the organs. The highly orchestrated procedure required close coordination.

“The coordination starts long before we even get to the operating room,” said Steggerda, Sams’ kidney surgeon. “It starts with our program coordinators and our respected nursing staff, who make sure that a donated organ is acceptable, identify the best time to do the procurement, and organize the logistics of getting all the teams there to get the organs and bring them back safely.”

During multi-organ transplants, surgeons operate based on allowable ischemic time–the amount of time each organ can tolerate being outside the body. Based on this, the heart transplant must happen first, followed by the liver and finally the kidney.

“The first step is the heart transplant, which is actually done in the same technical fashion that a single heart transplant is done: median sternotomy, cardiopulmonary bypass, removal of the old heart, suturing in the new donor heart, then coming off the bypass circuit,” said Gunn. “At that point, it changes. We leave the heart and the chest open, allowing the liver team to do their anastomosis [making connections] as well. And then ultimately the kidney is transplanted, followed by the closure of the chest.”

Nissen, surgical director of the Liver Transplant Program and Sams’ liver surgeon, said that multi-organ transplants like this exemplify transplant teams’ ability to work together under pressure.

“There's probably no better case in surgery or in medicine that exemplifies the concept of teamwork like a multi-organ transplant, because literally every team member has to work with every other team member for this to go right,” Nissen said. “The anesthesiologists work with the surgeons, the surgeons work with the technicians, and there are three different teams that are making this happen, so for this to be successful, it takes an absolutely coordinated effort. And it's the ultimate example of medical teamwork.”

According to transplant center Director Kim, not all medical centers in the U.S. offer organ transplants, and even among those that do, not many offer even dual organ transplants, let alone triple organ transplants.

“At Cedars-Sinai, we are one of the world’s leaders in dual organ transplants,” she said. “While no transplant center is doing triple organ transplants very routinely, our expertise in dual organ transplant management gives us an advantage when performing these complex, multi-organ procedures.”

His doctors say that, with Sams’ careful adherence to his medications and determination to rebuild strength, he should make a full recovery. He’s already back to doing some of the things he loves most–like coaching youth baseball. And much to Sams Sr.’s delight, son Vee is enrolled in film school, inspired by his father.

“The little things are so important,” Sams said. “We take advantage of a lot of little things, but now I know that those little things are where it’s at.”

Sams said he hasn’t yet met the family of the organ donor who saved his life, but if he does get the chance, he’ll tell them how grateful he is.

“I want them to know that I’m very appreciative, and that I’m going to do the best that I can to do a lot of good things,” Sams said. “His memory is still going, through me, and I’m going to do my best to honor it.”

Read more on the Cedars-Sinai Blog: 7 Myths About Organ Donation