Esther Vespa, 55, of Mt. Lebanon had played tennis a little as a young person, but didn't take up the sport seriously until 2005. Then she suffered a setback. In July of 2007, she was admitted to UPMC with acute liver failure.

Ms. Vespa was fortunate to get a liver transplant within days of being put on the list, but her medical problems weren't over.

"Five months post transplant, I was diagnosed with Hodgkin's lymphoma and received six months of chem therapy," she said. "The new organ tolerated the chemo and I have done well since that time, but it's been a long road back."

A milestone on the road back came last year, when she attended a clinic at the Mt. Lebanon tennis center. There she struck up a conversation with Stephanie Fedro-Byrom, 35, also of Mt. Lebanon. Ms. Fedro-Byrom had been on her high school tennis team in Virginia, but had only recently returned to the sport.

Ms. Vespa mentioned to Ms. Fedro-Byrom she was eager to attend the clinic because she wanted to recover the ground she lost when she'd had the liver transplant two years before.

It turned out that the younger woman had had a liver transplant in 1998, when she was 23 and just out of college, and liver transplants were rare.

Ms. Fedro-Byrom's kidneys shut down because her liver was missing an enzyme that filters oxalates from the blood, so they were building up in her kidneys. (Oxalates are organic acids routinely made by our bodies and contained in many of the foods we eat. Excessive amounts of them can lead to the formation of kidney stones and to oxalate poisoning.) She went on dialysis to slow the buildup of oxalates in her kidneys, bones and eyes, but the only way to stop the process was to replace her defective liver with one that had the missing enzyme.

The first successful liver transplant in humans was in 1963, but the procedure remained experimental for nearly two decades, with the survival rate after one year not exceeding 25 percent. The introduction of cyclosporin in 1980 -- an immunosuppressant drug which substantially reduced the likelihood the body would reject the new liver -- greatly increased survival rates.

But the procedure was used mostly for children, and the typical liver donor in those days was deceased. The first successful liver transplant from a living donor was in 1989. The first successful adult-to-adult liver transplant from a living donor took place while Ms. Fedro-Bryom was undergoing dialysis.

Her mom was working as an assistant to the sales director at a television station in Portsmouth, Va. After the first adult-to-adult liver transplant from a living donor was publicized, the station's sales director, a young father named David Rogers, volunteered to donate part of his liver to the daughter. Ms. Fedro-Byrom became the recipient of the second-ever adult-to-adult liver transplant.

She also required a new kidney, which she received from her older sister, Pam. Since then, she's made a remarkable recovery. Stephanie married Brad Byrom in 2001 and has two children, Grayson David (named after her liver donor), 5, and Ally, 3.

The two Mt. Lebanon women became fast friends. They decided to compete together in doubles tennis at the U.S. Transplant Games. The Transplant Games are sponsored by the U.S. Kidney Foundation and are held every other year. This year, they'll be held in Madison, Wis., July 30 to Aug. 4. In 2008, they were held in Pittsburgh.

About 80 transplant recipients, donors and donor family members from Pittsburgh will be attending this year's games. Shelley Zomak, 42, a registered nurse who is the unit director for cardiothoracic transplant at UPMC, is the team manager for the Pittsburgh transplant athletes.

Ms. Zomak has worked in transplant surgery since shortly after completing nursing school 21 years ago.

"It seemed the best fit for me," she said. "You get some of the sickest of the sick and you help to make them better."

The Transplant Games speed the recovery of transplant recipients, Ms. Zomak said.

"The games just open the door for so many people," she said. "I've seen a lot of people who get motivated. You see them go from being hesitant and withdrawn to being active. Transplant is scary for so many people. Having them see others who have been through transplant and what they can do helps set a higher bar."

One who was so motivated is Jim Uhrig, 64, of Peters. He had pulmonary fibrosis, a disease for which there is no known cure.

"I was diagnosed in May 2008," he said. "I was put on oxygen in July. I was using it about half the time by September, 100 percent of the time by Thanksgiving."

Being tied to an oxygen tank was hard on him. He had played football and baseball at Bethany College in West Virginia, and had remained active as an adult until the disease struck him down.

Mr. Uhrig got a double lung transplant in April of last year. It came just in time, because he was failing fast.

"My doctor said I was very lucky. I only had six to eight weeks [to live]," Mr. Uhrig recalled.

He first learned about the Transplant Games while he was recovering from his surgery.

"After surgery, you get moved to a transition floor," he recalled. "On that floor there are all these pictures of people in the Transplant Games. It's motivating."

He's back at work as sales manager at a refractory company, and is rebuilding his strength. He's been playing 18 holes of golf two to three times a week to prepare to compete in golf at the games. He also walks a mile or so most mornings, and a mile or two in the evenings.

"I'm breaking 100 now regularly," he said. "I really think I'm a better golfer now than I was before."

But golf is just the start of his ambitions:

"In the Transplant Games in two years, I want to be a sprinter."

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