Justin Kist played football all through Shaler Area High School with no health problems. Then, in late July 2006, just weeks after his graduation, he found himself struggling to breathe while playing Frisbee with his dad on a beach in Ocean City, Md. By nighttime Mr, Kist, just 18, was so short of breath he couldn't even play a round of miniature golf.

After an overnight stay in a local hospital, Mr. Kist was transported by helicopter to Allegheny General Hospital, where tests showed his heart was enlarged to about twice its normal size. He was placed on the list for a heart transplant, and, on Aug. 7, 2006, he got one.

"He was pretty sick," said Dr. David Dean, the surgical director of heart transplantation for AGH and Mr. Kist's surgeon.

"We were probably within a week of going to put a [heart] pump into him if he didn't get transplanted."

Now 20, Mr. Kist is getting ready to compete in 3-on-3 basketball for Team Pittsburgh in the National Kidney Foundation U.S. Transplant Games here July 11-16. "I can't wait," Mr. Kist said.

Mr. Kist's condition is called nonischemic cardiomyopathy, which means the cause of the enlargement is unclear, Dr. Dean said. In his case it could have been hereditary: A cousin also has had a heart transplant, and Mr. Kist's father has a mild heart condition.

Regardless the cause, Dr. Dean believes the onset of Mr. Kist's heart problem was quick. "He wouldn't have been able to play sports with it," Dr. Dean said.

"... I've transplanted kids who were doing great at soccer camps. They get anorexic, get a cold, you do an X-ray and their heart is huge and not functioning. ... His heart was just not going to recover."

But once he had the surgery, Dr. Dean said, Mr. Kist's recovery "was pretty non-eventful. ... He's been playing basketball since the transplant. Our patients do great after they get a new heart."

In addition, the surgeon said, "I think Justin has handled [the psychological aspects] very well. He has this new heart; he's coming up on the second anniversary of his transplant. [Heart transplant patients] know they don't last forever. ...

"Most people in their 20s think they'll be 80 or 90 when they die. They're not thinking they'll need another heart in 15 to 20 years."

Mr. Kist said it took him a while to fully comprehend what he went through.

"Everything was just going so fast, I just sort of was going along with it," he said.

"A couple months later, I sort of started to understand. I realized how lucky I was -- to have everything match perfectly."

Mr. Kist, who takes two immunosuppressant drugs along with multiple antibiotics, entered West Virginia University a few months after his transplant but found it was a little too soon to live that far from home. Instead he has been taking courses at Community College of Allegheny County, and he hopes to try WVU again, perhaps as soon as the next spring semester. He wants to major in sports management.

This summer he's working part-time as a cook at the Shaler Lounge and getting ready for the Transplant Games by playing pickup basketball at a park near his home.

For more information about the Transplant Games or organ donation, go online to www.transplantgames.org.