When Zsofia Karetka lines up with nearly 2,000 other runners aiming to complete the Glass City Marathon on Sunday, it will be a family celebration of life.
An Ohio woman, the 19-year-old grew up in Chesterland, Ohio, just east of Cleveland, is studying industrial engineering technology at the University of Dayton and has chosen Toledo to mark the success of her liver transplant and new hope for the future.
“I wanted to test my recovery,” said Zsofia Karetka, who had played soccer and lacrosse in high school.
Running a marathon had never been on her bucket list — until now.
“I am looking forward to it. It is a nice course and it is close to home," said Zsofia Karetka, who had studied the various marathons available and picked the Glass City marathon. “It is not too big that it will be scary, but big enough that the energy will be there.”
To prepare, she ran in the 2023 Transplant House of Cleveland 5K and a half-marathon in Indianapolis in June. She loosely consulted the Nike Run Club app to help her consistently increase her miles and provide guidance on pacing, but she tailored the plan to her own body and how she was feeling.
Zsofia Karetka overcame many hurdles to get to Sunday's starting line, where her parents and younger sister will cheer her on.
A body’s betrayal
During Zsofia Karetka’s high school years, there were disconnected symptoms that did not seem to point to any one illness. She suffered from dry skin. She had a low blood platelet count and a hormonal imbalance that resulted in late development as an adolescent. She had high cholesterol.
“She was such an active girl,” Livia Karetka, Zsofia's mother, said. “It did not make sense that she would have high cholesterol.”
Zsofia Karetka’s final year in high school sometimes frustrated her. She was unable to finish her soccer season because her spleen was enlarged. Doctors warned that if a ball hit her in the spleen there could be serious consequences.
“Her whole senior year was going doctor to doctor. She was not able to do contact sports,” said Livia Karetka, noting that her daughter's skin started taking on a yellowish cast. “People were noticing it and making not very nice comments about her skin tone.”
Just before starting her freshman year at Dayton, she came down with an infection and stayed in the hospital a week as her temperature rose to 103 degrees. A doctor decided to order a liver panel blood test.
“All her liver indicators were bad. She was dying,” Livia Karetka said. “It was super scary and hard to take it all in. It came as a shock.”
In fact, the condition of Zsofia Karetka's liver was likened to that of a 70-year-old alcoholic and was functioning at just 25 percent. All the disparate symptoms were signs that her body was slowly shutting down. She was told that she would need a liver transplant within six months.
“I made it through my first semester fine, but I got really yellow, had trouble digesting food, and retaining fluid,” she said. “Everyday, I got more sick.”
“We don't know why her liver started to fail,” said Dr. Choon Hyuck David Kwon, director of Minimally Invasive Liver Surgery at Cleveland Clinic's Digestive Disease Institute, adding that no genetic or environmental factors were uncovered.
About 3,000 people die annually while waiting for a liver transplant, according to data compiled by the United Network for Organ Sharing. However, Zsofia Karetka would have the option for a living donor: her mother. The liver has a unique ability to regenerate from just a portion of itself.
“She is a really healthy person, and I would be getting a healthy liver,” Zsofia Karetka said of her mother.
A day of success
What followed was a 14-hour surgery on Jan. 9, 2023.
“We had one team dedicated to the donor and one team for the recipient,” said Dr. Kwon, who led the donor team. “It is a complicated procedure, and we were working simultaneously.”
Dr. Kwon performed a laparoscopic procedure, which does not require a large incision during surgery. Instead, it is performed with surgical tools and a camera inserted through a few half-inch holes in the abdomen of the donor. The noninvasive procedure results in less scarring, shorter recovery time, less pain, and lower risk of an incisional hernia for the donor.
The survival rate for the liver recipient is 75 percent after one year and 53 percent after 20 years, according to Cleveland Clinic, noting its main campus completed 19 living-donor liver transplants in 2023. Both Zsofia Karetka and her mother recovered remarkably well.
Zsofia Karetka's ongoing symptoms disappeared once she had her new liver, and she credits much of her recovery to getting up and doing lots of walking.
“We are extremely proud of her and how she handled this from diagnosis to surgery,” Livia Karetka said.
“To be able to run a full marathon or a half marathon is amazing,” Dr. Kwon said. "It is a life-saving procedure ... It is known that as long as you take good care of yourself, the life expectancy will be very, very long.”
First Published April 26, 2024, 10:21 p.m.
