Miriam Nieves, a 62-year-old HIV-positive grandmother, has much to be grateful for this Thanksgiving. For one thing, the Westchester, New York, resident has a new heart. This past spring, she received the world’s first HIV-positive to HIV-positive heart transplant (she also received a simultaneous kidney transplant). And for another thing, Nieves returned to Montefiore Health Center in Bronx, New York, this week and was able to meet the donor’s family for the first time and express her gratitude. The donor, Brittany Newton, lived in Louisiana and died at age 30.

“I am so grateful to the Newton family and to Montefiore for taking a chance and extending my life,” Nieves said in a Montefiore press statement. “I hope other people see my story and start the conversation about organ donation as they gather with their families this Thanksgiving. I also hope to inspire more people to become organ donors and see that they have the power to save lives.”

“Sadly, many people with HIV waiting for a heart never receive one,” added Nieves’s cardiologist at Montefiore, Omar Saeed, MD, MS, who is also an associate professor of medicine at the hospital’s Albert Einstein College of Medicine. “By successfully managing Ms. Nieves’s care, we have shown that HIV-positive donors are a lifeline, and we encourage more people to consider sharing this lifesaving gift.”

The successful transplant is only the latest of many triumphs for Nieves, who beat drug addiction—a period during which she contracted HIV—enjoyed a career, raised three children with her husband of 27 years, Julio Pagan, and is a proud grandmother to six grandchildren. In fact, several of her family members accompanied her to the meeting with the donor’s family.

From left: Bridgette Newton with a photo of heart donor Brittany Newton, transplant recipient Miriam Nieves and her husband, Julio Pagan

HIV-positive heart transplant recipient Miriam Nieves (in red) with family members of donor Brittany Newton and the medical team at MontefioreCourtesy of Montefiore Health System

For many years, Nieves controlled her HIV and was healthy, but in 2006, she began experiencing health issues and was diagnosed with kidney cancer. The cancerous kidney was removed, but when the remaining kidney started to fail, she had to undergo dialysis every night. By the time a match for a kidney transplant was found, her heart was not healthy enough for the surgery.

Nieves had been on a heart transplant waiting list for “for quite a bit of time,” Saeed told Bronx Times when the transplant was announced last summer. So to increase her chances of finding a donor, Saeed and his medical team asked whether she’d be willing to receive a transplant from another person with HIV. “She was really completely fine with [that] and accepted the risks and benefits and signed consent,” Saeed said, adding: “This is a major accomplishment for us. But for me, I am in awe of her bravery, and I’m just amazed by her strength.”

The groundbreaking transplant took place nearly a decade after Congress passed the HIV Organ Policy Equity (HOPE) Act, which President Barack Obama signed into law in 2013. Before that, transplants between two HIV-positive people were illegal.

The first HIV-to-HIV transplant didn’t take place until 2016, when Johns Hopkins Medical Center in Baltimore performed the nation’s first organ transplants (a kidney and liver) from an HIV-positive donor to HIV-positive recipients. These two transplants, like most since, involved a deceased HIV-positive donor.

In 2019, Nina Martinez, a 36-year-old Atlanta woman who had contracted HIV from a blood transfusion as a newborn, became the first living HIV-positive kidney donor.

In related news, the federal government revised guidelines for organ transplants in June 2020 that could result in more organ donations. Notably, the update included new criteria for identifying donors with potentially undetected HIV and hepatitis B and C viruses (HBV and HCV). Thanks in part to advances in testing and treatment, more organs can now be accepted from people who would have been classified as an increased risk donor.