SINGAPORE – Mr Herman Sing, 45, wanted to donate an organ – any organ.

He also wanted to donate it to a stranger.

The Singaporean father of four has undergone surgery to fulfil his goal, giving almost 70 per cent of his liver to a sufferer of end-stage liver disease who is not known to him. The Straits Times is unable to reveal when the procedure took place, to comply with guidelines relating to recipient anonymity.

Mr Sing says his momentous decision “evolved naturally” over years of pondering the issue of doing good.

After more than 15 years of enthusiastic volunteer work, he wanted to do more. He wanted to “save a life”.

“I wanted to donate any organ to a stranger, as long as I could do it as a living donor. This is the only way you can save another person’s life directly,” he says.

Mr Sing works as a logistics director at a company that provides clinical trial laboratory services globally, a line of work that influenced his thinking.

He is married to Ms Lim Pei San, 45, a senior manager in the public service. The couple have four children aged five, nine, 13 and 17.

Cases of living organ donations to an anonymous recipient are rare in Singapore. There have been four such successful donations since 2018, says a spokesman for the National Organ Transplant Unit, Ministry of Health.

The spokesman adds that organs that can be donated while an individual is alive include the kidney and part of the liver.

In Singapore, while most living donors are related to the recipients, individuals may also choose to donate to patients on the national waiting list. For such non-directed donations, the donor may approach the unit, which will facilitate the process.

Deceased donors accounted for 16 liver transplants and 22 kidney transplants in 2022, according to statistics from the unit.

Mr Sing began volunteering with various non-profit organisations in his 20s, after graduating with a business degree from the National University of Singapore. He felt he had better control of his finances and time at that stage in his life.

Enlisting his wife, children and colleagues along the way, he found charitable work a “two-way street” that benefited the needy individuals he served and yielded many happy memories for him.

He still delivers food packages to low-income households, recalling how this had moved one recipient, who had recently been widowed and suffered a stroke.

For several years, he took annual leave to spend two weeks in December distributing groceries and gifts to the needy during the Boys’ Brigade’s Share-a-Gift Christmas campaign.

In his early days of volunteering, Mr Sing, a Buddhist, was part of a group that chanted prayers at strangers’ wakes. While serving bereaved families, he realised that good deeds need not be done only for people one knew.

“I got into a routine of giving back to society. But I felt I could not address the root cause of the other person’s suffering. I started to think, what more can I do?” he says.

Working in the clinical trials sector, where “everyday work is about saving lives”, resonates with him, he adds. 

A few years ago, he signed up for the Bone Marrow Donor Programme, which manages Singapore’s register of volunteer bone marrow donors.

He also tried giving blood, quickly switching to donating blood plasma and platelets, a longer and more complicated procedure than the jab in the arm required for blood donation. “I could do it more frequently, on a monthly basis, instead of once every three months (with blood donation). To date, I have donated 64 times,” he says.

When personal tragedy struck, it strengthened his altruistic resolve.

In 2007, he quit his job to become a full-time caregiver, together with his mother, after his father was diagnosed with colon cancer. He resumed work in the logistics industry after his father died two years later at the age of 59. 

He recounts: “It was a key factor in me wanting to donate part of my liver. I feel that I can truly make a difference in another person’s life and family. Going through my loved one’s terminal illness helped me tolerate the pain of my surgery.”

Mr Sing approached the National Organ Transplant Unit a couple of years ago, kicking off a lengthy and rigorous series of medical, psychological and other tests in a bid to become a living organ donor.

He decided to donate part of his liver, rather than a kidney, because he figured that a liver transplant would likely be the last resort for a liver patient, while a patient waiting for a kidney transplant can undergo dialysis.

Mr Sing’s surgeon, Associate Professor Shridhar Iyer from National University Hospital (NUH), outlines the risks.

“Worldwide figures show that there is a mortality risk for donors of 0.5 per cent or less, while 15 to 20 per cent of donors may suffer complications, which can include bleeding or infections,” says the co-director of the National University Centre for Organ Transplantation at NUH. Major complications constitute less than 2 per cent for such procedures done at the centre, he adds.

One of Mr Sing’s biggest challenges was informing the people around him about his decision.

The first person he told was his wife, who burst into tears when she heard the news. Friends and family also tried to dissuade him from cutting open his body for a stranger.

In response, he told them there is no “best time” for him to do this, even though his youngest child is just five, and that the risks would be the same even if he donated an organ to someone he knew. He urged everyone to focus on the overwhelmingly high chances of survival.

He even wrote a 1,700-word letter that he gave to those he confided in, describing his reasons.

“There’s a Chinese version too,” he says, adding that he penned the missives partly because he did not want his wife or 74-year-old mother to be held responsible if anything untoward happened.

The night before the surgery, final hospital tests showed an unexpected detail.

Mr Sing’s cystic duct, located near the liver, is irregularly shaped, which might affect the procedure.

When his wife heard, she nearly collapsed.

“Everything went numb and cold, and I felt giddy,” recalls Ms Lim. “It was something abnormal, and it was very worrying.”

Mindful of the “disappointment” that the liver recipient would feel if the operation were to be cancelled at the last minute, Mr Sing persuaded his wife that he should go through with it.

Dr Iyer eventually made some technical modifications to the procedure, which went smoothly.

About 67 per cent of Mr Sing’s liver, which would regenerate itself, was excised.

He woke from the general anaesthesia feeling “relieved” that he had achieved his goal. During the first few days of recovery, the “eight out of 10” levels of pain he felt was eased with morphine. 

“I knew what I was getting into. I have no regrets. It’s saving a life,” he says.

His wife adds: “I think he is someone who is quite extraordinary.”