research impact
Serendipity to Standard of Care: Durand’s Work to Revolutionize Solid Organ Transplantation among People Living with HIV
"It's remarkable how much we've accomplished over a decade, to go from HOPE Act implementation to having policy that says you can do these transplants as clinical care"
Christine Durand, M.D.
Published in
IDeas Magazine -
Spring 2026
Christine Durand, M.D., didn’t set out to change the field of transplant medicine. She entered medical school at the Johns Hopkins University School of Medicine with her sights set on training in public health or international health. Transplant and oncology infectious diseases, a relatively young field even now, was not on her professional radar.
She first developed an interest in infectious diseases in medical school, taking a year off to focus exclusively on the study of HIV under Robert Siliciano, M.D., Ph.D., Janet Siliciano, Ph.D., and Joel Gallant, M.D., M.P.H., in the Division of Infectious Diseases. During her residency, also at Johns Hopkins, Durand spent significant time on the bone marrow transplant service with mentor Richard Ambinder, M.D., Ph.D., director of the Division of Hematologic Malignancies at the Johns Hopkins Kimmel Cancer Center. This new clinical pursuit piqued her curiosity about the practice of transplant medicine. The rest, she says, was just about being in the right place at the right time.
“As I was trying to make the transition to fellowship and eventually faculty, we had a transplant ID expert in HIV who was leaving [Johns Hopkins]. There was just this need. I had the interest and the background in HIV, but also this new interest in transplant, so it seemed like a really great fit,” Durand says.
Serendipity intervened again when it came time to solidify her research focus.
“One of the transplant surgeons at Hopkins, who was mainly a big data and policy expert, had just worked to envision and get the HOPE Act passed, which legalized HIV-to-HIV transplant, but required it be done under research,” she remembers. “He needed a partner who had expertise in HIV, and I was sort of the natural person for him to reach out to.”
The transplant surgeon was Dorry Segev, M.D., Ph.D., now head of the Center for Surgical and Transplant Applied Research at New York University Langone Health. While at Johns Hopkins, Segev and research assistant Brian Boyarsky, M.D., Ph.D., published a landmark 2011 study that estimated 500 people living with HIV would be eligible for lifesaving solid organ transplants each year if a federal ban on HIV-to-HIV transplants was overturned. In 2013, President Barack Obama signed into law the HIV Organ Policy Equity (HOPE) Act, making it possible for researchers to study the safety and efficacy of organ transplants between people with HIV.
Since 2015, Durand and her team have worked to build the HOPE in Action consortium, a network of 26 transplant centers across the United States that engage in the clinical research required by the HOPE Act. The first deceased-donor HIV-to-HIV kidney and liver transplants were conducted by Johns Hopkins Medicine in 2016, followed in 2019 by the first living donor HIV-to-HIV kidney transplant in the U.S. A series of studies from 2020–24 by Durand and HOPE in Action researchers demonstrated that kidney donations from people with HIV were just as safe as those from donors without HIV. As a result of these findings, the U.S. Department of Health and Human Services in November 2024 lifted the research-only distinction for transplantation of kidneys and livers from donors with HIV to recipients with HIV. The policy change established HIV-to-HIV transplants of these organs as routine clinical practice — safe, effective and ready to be implemented immediately to save lives.
“It’s been remarkable how much we’ve accomplished over a decade, to go from the HOPE Act implementation to now having policy that says you can do these transplants as clinical care,” Durand says.
She admits that progress sometimes felt slow, as providers often needed reassurance that improvements in HIV care meant the goal of HIV-to-HIV transplants was within reach.
“In the beginning, I think there was a lot of hesitancy from providers across disciplines,” Durand notes. “Even if we had the infectious disease physicians convinced that HIV was a manageable disease, we had to talk to surgeons, we had to talk to kidney transplant specialists, liver transplant specialists … we had a whole group of nurses and physicians who worked with potential deceased donors who had to learn that HIV wasn’t a death sentence, that donors with HIV could be suitable donors.”
Patient outreach and education is equally critical in advancing HOPE in Action’s current work, which involves exploring HIV-to-HIV heart and lung transplants and further expanding the donor pool to include organs from people with other infections like hepatitis C and Kaposi’s sarcoma herpesvirus. Bridging the information gap for people living with HIV and other infections who might be considering organ donation is a special area of concern for Durand.
“A lot of people with HIV don’t know they can register as organ donors … no one asks about your HIV status. You don’t need to do anything special if you have HIV [and want to become an organ donor].”
HOPE in Action patients who share their stories are invaluable to the consortium’s efforts.
“Despite how far we’ve come in terms of medical advances, there’s still a lot of stigma and fear that surrounds this [HIV] diagnosis. There are some participants who I think are extraordinarily brave who have come forward with their stories. Highlighting patient stories and lifting up patients’ voices can do a lot … [organ transplant] recipients willing to go on record as a person with HIV and put a face to that diagnosis is so important,” Durand says.
Changing the standard of care for organ transplant recipients, expanding the donor pool and advancing scientific understanding of infectious diseases in transplant medicine are certainly career benchmarks for Durand, but what she’s most proud of is the program she’s built and the team that sustains it.
“[Along with research nurse manager] Diane Brown, we built a really great work culture where we’re pushing people to grow and develop, but it’s a compassionate and supportive environment. Just watching people who’ve spent time with us go on, the skills they’ve developed, their journey has been really rewarding,” she says.
As for what comes next, Durand says the unpredictable nature of infectious diseases is something that keeps her motivated. The great thing about ID, she says, is that you never know what’s coming.
“There’s always an emerging pathogen, a new drug, a new surgical procedure … infectious risks or consequences we don’t think about. The envelope is always being pushed, and that’s always exciting.”
After all, being ready for anything is how it all started for Durand.
“I always tell trainees, you don’t have to have it figured out. I never would have pictured my career today five or 10 years ago. It’s about trying to gather different skills along the way so that you’re ready when an opportunity arises,” Durand says.
She first developed an interest in infectious diseases in medical school, taking a year off to focus exclusively on the study of HIV under Robert Siliciano, M.D., Ph.D., Janet Siliciano, Ph.D., and Joel Gallant, M.D., M.P.H., in the Division of Infectious Diseases. During her residency, also at Johns Hopkins, Durand spent significant time on the bone marrow transplant service with mentor Richard Ambinder, M.D., Ph.D., director of the Division of Hematologic Malignancies at the Johns Hopkins Kimmel Cancer Center. This new clinical pursuit piqued her curiosity about the practice of transplant medicine. The rest, she says, was just about being in the right place at the right time.
“As I was trying to make the transition to fellowship and eventually faculty, we had a transplant ID expert in HIV who was leaving [Johns Hopkins]. There was just this need. I had the interest and the background in HIV, but also this new interest in transplant, so it seemed like a really great fit,” Durand says.
Serendipity intervened again when it came time to solidify her research focus.
“One of the transplant surgeons at Hopkins, who was mainly a big data and policy expert, had just worked to envision and get the HOPE Act passed, which legalized HIV-to-HIV transplant, but required it be done under research,” she remembers. “He needed a partner who had expertise in HIV, and I was sort of the natural person for him to reach out to.”
The transplant surgeon was Dorry Segev, M.D., Ph.D., now head of the Center for Surgical and Transplant Applied Research at New York University Langone Health. While at Johns Hopkins, Segev and research assistant Brian Boyarsky, M.D., Ph.D., published a landmark 2011 study that estimated 500 people living with HIV would be eligible for lifesaving solid organ transplants each year if a federal ban on HIV-to-HIV transplants was overturned. In 2013, President Barack Obama signed into law the HIV Organ Policy Equity (HOPE) Act, making it possible for researchers to study the safety and efficacy of organ transplants between people with HIV.
Since 2015, Durand and her team have worked to build the HOPE in Action consortium, a network of 26 transplant centers across the United States that engage in the clinical research required by the HOPE Act. The first deceased-donor HIV-to-HIV kidney and liver transplants were conducted by Johns Hopkins Medicine in 2016, followed in 2019 by the first living donor HIV-to-HIV kidney transplant in the U.S. A series of studies from 2020–24 by Durand and HOPE in Action researchers demonstrated that kidney donations from people with HIV were just as safe as those from donors without HIV. As a result of these findings, the U.S. Department of Health and Human Services in November 2024 lifted the research-only distinction for transplantation of kidneys and livers from donors with HIV to recipients with HIV. The policy change established HIV-to-HIV transplants of these organs as routine clinical practice — safe, effective and ready to be implemented immediately to save lives.
“It’s been remarkable how much we’ve accomplished over a decade, to go from the HOPE Act implementation to now having policy that says you can do these transplants as clinical care,” Durand says.
She admits that progress sometimes felt slow, as providers often needed reassurance that improvements in HIV care meant the goal of HIV-to-HIV transplants was within reach.
“In the beginning, I think there was a lot of hesitancy from providers across disciplines,” Durand notes. “Even if we had the infectious disease physicians convinced that HIV was a manageable disease, we had to talk to surgeons, we had to talk to kidney transplant specialists, liver transplant specialists … we had a whole group of nurses and physicians who worked with potential deceased donors who had to learn that HIV wasn’t a death sentence, that donors with HIV could be suitable donors.”
Patient outreach and education is equally critical in advancing HOPE in Action’s current work, which involves exploring HIV-to-HIV heart and lung transplants and further expanding the donor pool to include organs from people with other infections like hepatitis C and Kaposi’s sarcoma herpesvirus. Bridging the information gap for people living with HIV and other infections who might be considering organ donation is a special area of concern for Durand.
“A lot of people with HIV don’t know they can register as organ donors … no one asks about your HIV status. You don’t need to do anything special if you have HIV [and want to become an organ donor].”
HOPE in Action patients who share their stories are invaluable to the consortium’s efforts.
“Despite how far we’ve come in terms of medical advances, there’s still a lot of stigma and fear that surrounds this [HIV] diagnosis. There are some participants who I think are extraordinarily brave who have come forward with their stories. Highlighting patient stories and lifting up patients’ voices can do a lot … [organ transplant] recipients willing to go on record as a person with HIV and put a face to that diagnosis is so important,” Durand says.
Changing the standard of care for organ transplant recipients, expanding the donor pool and advancing scientific understanding of infectious diseases in transplant medicine are certainly career benchmarks for Durand, but what she’s most proud of is the program she’s built and the team that sustains it.
“[Along with research nurse manager] Diane Brown, we built a really great work culture where we’re pushing people to grow and develop, but it’s a compassionate and supportive environment. Just watching people who’ve spent time with us go on, the skills they’ve developed, their journey has been really rewarding,” she says.
As for what comes next, Durand says the unpredictable nature of infectious diseases is something that keeps her motivated. The great thing about ID, she says, is that you never know what’s coming.
“There’s always an emerging pathogen, a new drug, a new surgical procedure … infectious risks or consequences we don’t think about. The envelope is always being pushed, and that’s always exciting.”
After all, being ready for anything is how it all started for Durand.
“I always tell trainees, you don’t have to have it figured out. I never would have pictured my career today five or 10 years ago. It’s about trying to gather different skills along the way so that you’re ready when an opportunity arises,” Durand says.