Daughter Forever Grateful to Mother for Life-Saving Liver Donation

Running in her first-ever marathon, Zsófi Karetka endured rain and humidity to cross the finish line in the University of Toledo football stadium. She was happy with her time of 4 hours and 21 minutes, and the 19-year-old finished second in her age group, with friends and family members cheering her on. Her accomplishment is an inspiring feat. Sixteen months earlier, Zsófi had received a living donor liver transplant thanks to the gift of life from her mother, Livia, who donated a portion of her liver. “I’m better than ever,” says the University of Dayton sophomore, who plays soccer and club lacrosse while majoring in industrial engineering. “I’m back to the same lifestyle I had before, if not more rigorous.”

In August 2022, Zsófi started her freshman year of college at the University of Dayton, where her older brother Levente was a sophomore.

She couldn’t have imagined doing anything athletic ever again. A few weeks before starting college, she was hospitalized for one week at Cleveland Clinic Hillcrest Hospital, with an infection related to her failing liver. She nonetheless eagerly embarked on the next phase of her life. At college, she would be living four hours away from her parents, two younger sisters and her Cleveland Clinic care team.

Livia and her husband, Levente, were worried about letting her go. “It was hard for us as parents in making that decision,” recalls Livia. “The fact my son was also at her school, and she would be fairly close to Cleveland, were the deciding factors.”

Zsófi first began experiencing various seemingly unrelated medical symptoms in the eighth grade. From high cholesterol to low levels of blood platelets, as well as hormonal imbalances and dermatological problems, physicians throughout Ohio couldn’t determine the cause of or an effective treatment for Zsófi’s health issues. That didn’t stop her from competing on her high school lacrosse and soccer teams, the latter of which she served as captain in her senior year.

A few months into her senior year at Hawken School, doctors diagnosed a cirrhosis of the liver, in which severe scarring can damage the organ and interfere with its ability to function.

According to Koji Hashimoto, MD, PhD, Director of Liver Transplantation at Cleveland Clinic and the surgeon who performed the liver transplant, the liver disease was advanced and Zsófi would likely need a liver transplant within a few years. Despite genetic testing and multiple imaging tests, including MRIs and CT scans, Dr. Hashimoto says, “We could not figure out the cause of her liver disease. We classified it as biliary-type cirrhosis with unknown etiology.”

As soon as Zsófi’s first semester at Dayton began in fall 2022, her condition worsened. She grew increasingly fatigued, endured near-constant stomach pain and experienced yellowing of her skin and eyes –signs her liver was rapidly deteriorating.

While Zsófi soldiered on, relying on her brother and her friends for emotional support at college, her Cleveland Clinic doctors added her to the national transplant waiting list for organ donation. One of the largest liver transplant programs in the U.S., Cleveland Clinic also specializes in living-donor liver transplants for both adult and pediatric patients.

Because the liver can regenerate, the liver of a living donor usually grows back in six to eight weeks. Both of Zsófi’s parents learned about living liver donation and began undergoing testing to determine if they were a match. Zsófi’s father, Levente, was not, but Livia learned she could be her daughter’s donor.

“We got the news around Christmas time and were so excited,” says Livia. “At last, we knew something could be done, sooner than later.”

Livia’s surgeon was Choon Hyuck David Kwon, MD, PhD, Director of Minimally Invasive Liver Surgery at Cleveland Clinic. Livia was a candidate for a laparoscopic surgical technique Dr. Kwon is able to perform for removing the living donor’s piece of liver for a liver transplant. Unlike open surgery, patients have smaller scars and experience reduced pain and a shortened recovery time after surgery with the laparoscopic technique.

“Following the laparoscopic procedure, most of our living liver donors can go home in less than a week. Many are back to work and their normal routine within about one or two months,” Dr. Kwon explains. “The scar is a lot smaller compared to open surgery, but many of our patients see it as a scar of pride for saving a life.”

Livia and Zsófi were prepped for their respective surgeries in adjacent operating rooms. They virtually called each other that morning, and unexpectedly, met in the hallway outside their operating rooms.

Zsófi recalls, “They rolled me past her, but I didn’t have my glasses on. I said, ‘Is that my mom?’ It was so awesome we got to see each other before our surgeries, just to say, ‘I love you,’ and that we’ve got this together.”

Both the living donor surgery and the liver transplant were completed without complications in January 2023. While Zsófi experienced significant pain in the first few days following her liver transplant surgery, she dutifully began walking up and down the hallways of the hospital to regain her strength, with the encouragement of her father, who was her caretaker during the recovery, and often with Livia by her side.

“Maybe ‘nice’ isn’t the perfect word to describe it, but it was nice we did this together. We understood what each other was going through,” says Zsófi.

“It also helped we had an extensive support group of family, friends, and people across the globe who prayed for us, reached out to us with encouragement and offered their help,” says Livia. “Knowing our two younger kids were taken care of while my husband, Zsófi, and I were in the hospital allowed us to focus on Zsófi’s and my recovery.”

Dr. Kwon says about half of donated livers used for living donor liver transplants at Cleveland Clinic come from patients’ family members, and half come from friends or altruistic donors who simply want to help someone they know or even a stranger. “All donations are a wonderful gift,” he says. “When it’s a parent to a child, or vice versa, it’s always very emotional.”

Livia reflects on the special bond she has with her daughter, “Zsófi and I have always been close and this brought us even closer together, however, anyone in our family would have done it.”

Adds Zsófi, “My mom gave me a second chance at life. She gave birth to me, and with her liver, she birthed me again.”