If the Society of Organ Transplantation's (SOT) financial situation does not improve, this might be the last year that it sponsors transplant recipients to take part in the World Transplant Games (WTG).
Singapore will be sending 12 athletes to the WTG in Malaga, Spain, later this month, nine of whom will be partially sponsored by the SOT.
The society - which was formed to promote organ transplant and advocates an active life for patients - is fast running out of funds, its president, Dr Terence Kee, told The Straits Times. The senior renal physician at Singapore General Hospital said that with declining donations, "our fear is that we will not be able to support the athletes with the same financial capacity for subsequent Games".
Singapore has been sending participants to the WTG - which is recognised by the International Olympic Committee - since 1987.
Professor A. Vathsala, a senior renal physician at the National University Hospital and a former SOT president, said supporting transplant patients for the Games has always been a mission of the society.
It is not only a "source of inspiration for me and other healthcare professionals who advocate strongly for organ donation and transplantation", she said, but should also be an impetus for more organ donations as "it is true evidence of how well the patients have recovered".
"Such feats would be impossible without the gift of organ donation."
There are more than 6,000 kidney-failure patients who survive only because of regular dialysis. A transplant would greatly improve both their quality and length of life. Patients facing liver or heart failure would die without a transplant.
But this year, the SOT, whose members are healthcare professionals involved in transplants, could not even afford to send a team manager for the WTG.
Said Dr Kee: "Traditionally, one of our transplant coordinators would play the role of team manager. But due to insufficient funds, we have been unable to support a coordinator to attend over the past two Games."
The local biennial Games in Februarysaw 108 participants. Those who qualify for the world event based on their performance in the Singapore Games used to be fully sponsored. Now, they need to "contribute a small amount due to waning contributions".
The estimated cost is $5,000 per participant, though each of them needs to pay only $600. The cost covers flights, registration, accommodation, insurance, sporting gear and other "ancillary" expenses.
Three of the 12 athletes will be paying their own way - two of them because their results in the Singapore Games were not "within the winning times". The third is doing so because of the financial strain facing SOT.
Dr Kee added: "Organ recipients have a unique patient journey that spans loss of health, suffering with organ failure to a second chance at life with restoration of health after a transplant."
After a transplant, like any normal person, they can take part in any sport, except for boxing.
He added: "Athletes who have participated over decades serve as an inspiration to others who are just beginning their journey."
There are 276 people waiting for a kidney, 23 for a heart and 57 for a liver. Last year, 72 people received a kidney, 35 a liver and six a heart.
The society hopes Singapore, which had hosted the WTG in 1989, will do so again. The SOT also runs meetings and courses for transplant professional development. In 2015, it organised the Congress of the Asian Society of Transplantation.