Zackariah Pate loved being an uncle. Nieces Nataleigh Goodwin, 6, and Emileigh Griffith, 2, loved him back, especially when he took them outside to draw with sidewalk chalk or to search for worms. “That’s me and Emileigh and Aunt Ashleigh and Uncle Zack,” Nataleigh said, showing off a picture she drew while Ashleigh Blankenship spoke about the historic donation of her brother’s heart.

“I miss him very much.” Pate, who died July 9, made just the third HIV-positive-to-HIV-positive heart donation in the U.S.

this month at Sentara Norfolk General Hospital, Sentara spokesperson Dale Gauding said. Blankenship knew her 29-year-old brother, who lived with her in Portsmouth for most of the past two years, was an organ donor, but she and Pate’s two other sisters, Taylor Goodwin and Madison Tye, were stunned to learn the donation was possible a decade after he was diagnosed with HIV. “I know my brother would have wanted that,” she said.

“I feel like the HOPE Act needs more recognition.” The HIV Organ Policy Equity Act, passed in 2013, established a research program that made liver and kidney transplants legal for people with HIV. In May 2020, the act was expanded to include all organs, and the first HIV-positive heart transplant took place in 2022.

This was the first HIV-positive organ donation for Sentara Health, Gauding confirmed, and for Virginia Beach-based LifeNet Health, the federally designated organ management organization for most of Virginia, said Douglas.