Can one of your biggest sports rivals also be one of your biggest fans?
If you ask World Transplant Games competitors Erik Van Rompaye of Belgium and Germany’s Elmar Sprink, the answer is yes.
The two met in 2023 at the Games – an Olympic-style event designed to raise awareness about organ donation and encourage recipients to get fit – in Perth, Australia. Van Rompaye, 54, received a liver transplant in 2021. Sprink, 53, got a new heart in 2012. Both were already accomplished endurance athletes long before their surgeries.
Ahead of the Games, Van Rompaye heard that Sprink was “the man” to beat in Perth. He was right. But in the 5K road race and sprint triathlon, Van Rompaye edged the German out for gold with Sprink taking silver and bronze, respectively. On the medal podium, they struck up a conversation and discovered they’d both competed in the prestigious IRONMAN World Championship in Hawaii, a brutal triathlon competition that sees participants complete a 2.4-mile swim, 112-mile bike race and a marathon-distance run.
“Before that, I didn’t know anyone who was doing so much sport after a transplant,” Van Rompaye told CNN Sports. “Not those long distances. That was not so common at all.”
Since Perth, they’ve kept in touch, swapping notes on training, injuries and aging. This week, they’ll face each other again at the 2025 World Transplant Games in Dresden, Germany, yet both arrive in central Europe with new challenges to overcome. Nerve damage from Van Rompaye’s surgery has slowed his running while a recent back injury sidelined Sprink from a half marathon.
Around 2,200 participants – including organ donors and donor families – aged 4 to 89 from 51 countries will compete in events ranging from track and field to badminton, swimming, and even pétanque (a French boules sport).
Why they compete
Sprink has competed in several endurance competitions since his transplant, including three World Transplant Games and two 691K Cape Epic mountain bike races. He says he’s the first person with a heart transplant to complete the IRONMAN World Championship in Hawaii. Van Rompaye’s new liver has helped him complete the European Transplant Games, two Olympic distance triathlons – 1.5K swim, a 40K bike ride, and a 10K run – and the New York City Marathon.
Before their transplants, they both played soccer and ran other endurance races. Now, their goals are just as ambitious – Sprink wants to qualify for another IRONMAN World Championship, while Van Rompaye is training for the Ultra-Trail du Mont Blanc, one of the world’s most prestigious trail races with a distance of roughly 106.3 miles (171km) and an elevation gain of almost 32,940 feet (10,000m).
“It’s a bit of chasing dreams,” Van Rompaye said. “Life is about adapting … It’s not what happens to you, it’s what you do with it afterwards.”
Sprink agrees, telling CNN that he sees sports as a way to build purpose and good health: “If you look at the side effects of the medication, you can reduce some of them with sport – healthy nutrition, managing your weight and blood pressure, working out every day,” he said.
Common side effects of immunosuppressants, medications used to prevent organ rejection, include increased rates of cancer and diabetes , vomiting, and even hair thinning or loss.
“Focus on something and it makes you not think about the organ stuff so much,” he added.
The bigger picture of the Games
The World Transplant Games are built on decades of research showing that exercise improves transplant recipients’ physical and mental health.
Which organs have the participants had transplanted?
- Bone marrow/Stem cell – 144
- Double Lung – 69
- Heart – 169
- Heart-Lung – 3
- Kidney – 647
- Liver – 318
- Pancreas – 1
- Pancreas-Kidney – 16
- Pancreatic Islets Cells – 1
- Single Lung – 4
Germany was chosen as this year’s host country partly to address its low organ donation rates in comparison to other countries – just 11.6 deceased donors per million compared to 41.9 in the US and Spain’s 48.9. The reasons for this include long wait times and cultural and policy barriers to donation.
Almost all solid-organ recipients must take lifelong immunosuppressants, which can impact performance. The Games aim to level the playing field by having immunosuppressed athletes compete against one another.
Dr. Patricia Painter, a retired clinical exercise physiologist who studied transplant recipients at UCSF and the University of Utah, has measured how their bodies adapt – oxygen intake, muscle growth, recovery.
“Especially when you look at the comorbidities after transplant – hypertension, weight gain, diabetes – the prevention is diet and exercise,” she told CNN Sports. “Most people die of cardiovascular disease after transplant, not because of their transplant.”
Dr. Diethard Monbaliu, an abdominal transplant surgeon in Belgium who was part of Van Rompaye’s team, agrees: exercise is medicine. But for transplant athletes, he stresses moderation.
Strenuous training combined with immunosuppression can raise infection and cardiovascular problems.
“Mild to moderate exercise – up to about 60% of peak oxygen uptake – actually lowers infections,” he said. “But above that, you see the opposite.”
Transplant athletes are rare; IRONMAN finishers like Van Rompaye and Sprink are rarer still. Monbaliu says more research on high performance athletes is needed, but their presence proves that elite athletes belong at the Games too.
World Transplant Games President Liz Schick is a liver transplant recipient and describes herself as the type of athlete who “meets someone (in a race) who’s about to give up, sticks with them and stops them from giving up.”
She says the federation has discussed tailoring events for elite competitors, but stresses the Games are also about inclusion. “It’s great to be competitive and to want to win, but we mustn’t forget the others,” she told CNN Sports.
Rivalry redefined
For Sprink, what makes his friendship with Van Rompaye special is that it isn’t dominated by transplant talk. “In the beginning, sure, we said, ‘I’ve got a new liver, I’ve got a new heart.’ But after two sentences, we were on to racing plans and training problems … I love that much more because I don’t want to think over and over again about organ transplantation.”
Van Rompaye admits the Games sometimes make him wonder if he honors his donor enough – he has written to his donor’s family, while Sprink has not yet had contact with his. Both agree that mental health and well-being are just as critical as physical recovery.
“I always tell people: after the transplant, go look after your mental health right away,” Sprink said. “In the beginning, everyone is just happy to be alive. But a lot of people struggle in the post-transplant process.”
As they prepare to race again in Dresden, the medals matter – but the friendship may matter more. For Van Rompaye and Sprink, the Games are proof that rivalry can deepen respect, and competition can build connection.
If you are interested in following the Games, the opening and closing ceremonies and track & field events will live-streamed on YouTube and wtg.com.