This guide is for adults in Fort Worth and across North Texas who have advanced chronic kidney disease (CKD, a gradual, long-term loss of kidney function) or are already on dialysis, and for the family members and friends who may be wondering whether they could help. If a kidney transplant has come up in conversations with your nephrologist (kidney specialist), you have probably heard that a kidney from a living donor is often the best option. As of July 2026, 109,817 people were on the national transplant waiting list, and kidneys are the organ most often needed. In 2025, 6,521 kidney transplants in the U.S. came from living donors.
Asking whether someone you know could give you a kidney can feel overwhelming, even selfish. It is neither. This guide explains who can donate, what donation involves for the donor, what happens if your donor is not a match, and how to start the conversation.
The short answer: Yes. A living donor can be a family member, spouse, friend, coworker or even a stranger, as long as they are healthy enough to donate and pass a thorough evaluation at a transplant center. Donors do not have to be related to you, and a donor who is not a direct match can still help through a paired kidney exchange. A living donor transplant can often happen sooner than waiting for a kidney from a deceased donor, and sometimes before you need dialysis at all.
Medically reviewed by Michael Babigumira, MD, board certified by the American Board of Internal Medicine in nephrology and internal medicine, Fort Worth Renal Group. Last reviewed September 27, 2026.
Why a Living Donor Kidney Can Make a Difference
A kidney transplant replaces the work your own kidneys can no longer do. It is a treatment, not a cure, and it requires daily anti-rejection medicines for as long as the kidney works. For many people with kidney failure, though, it offers more freedom and a longer life than dialysis. Our overview of how a kidney transplant changes life covers that decision in more detail.
A kidney can come from a deceased donor or a living one. With a deceased donor kidney, you wait on the national transplant list until a suitable kidney becomes available, which can take years. According to the OPTN/SRTR 2024 Annual Data Report, 10.7 percent of kidney transplant candidates had been waiting five years or longer.
A living donor transplant works differently. Because the donor is healthy and alive, the surgery can be scheduled ahead of time, once both of you have been evaluated and approved. Living donor kidneys also tend to last longer. In the same report, among adults ages 18 to 34 who received a transplant between 2017 and 2019, 89.9 percent of living donor kidneys were still working at five years, compared with 82.5 percent of deceased donor kidneys. These figures are for the youngest recipients (ages 18 to 34), who tend to have the best outcomes; the gap held for older recipients too, and was wider among those 65 and older: 79.8 percent compared with 66.1 percent.
Timing matters too. When a living donor is identified early, some patients receive a transplant before they ever start dialysis, known as a preemptive transplant. That is one reason to start the living donor conversation while your kidney function is still declining, not after dialysis begins. If you are weighing treatment options now, our guide to dialysis options explains how transplant fits alongside in-center and home dialysis.
Who Can Be a Living Kidney Donor?
Most healthy adults ages 18 and older can be considered, according to Cleveland Clinic’s living donor program. Every transplant center sets its own criteria, and the final decision always rests with the center’s evaluation team. In general, a potential donor needs to:
- Be an adult who is choosing to donate freely, without pressure or payment
- Have two healthy kidneys and normal kidney function
- Pass a medical and psychological evaluation at a transplant center
- Have a blood type that is compatible with yours, or be willing to join a paired exchange if not
Conditions such as uncontrolled high blood pressure, diabetes, kidney disease, some cancers or significant obesity often rule a person out, because donating could put their own health at risk. The transplant team decides each case individually.
Your donor does not have to be a relative. Biological siblings are often the closest match, but spouses, friends, coworkers and members of your faith community donate every year. Some people also donate to someone they have never met, known as non-directed donation.
Blood Type Compatibility
Blood type is the first compatibility check. Based on the standard rules summarized by Cleveland Clinic:
| Donor blood type | Can donate to recipients with blood type |
|---|---|
| O | O, A, B or AB |
| A | A or AB |
| B | B or AB |
| AB | AB only |
Transplant teams also run tissue-typing and crossmatch tests to see how your immune system is likely to react to a donor’s kidney. A donor with a compatible blood type can still be a poor immune match, and the reverse can sometimes be managed.
What If My Donor Isn’t a Match? Paired Kidney Exchange
An incompatible donor is not the end of the road. In a paired kidney exchange, your donor gives a kidney to another recipient who matches them, and you receive a kidney from that recipient’s donor, or from a donor further along a chain of pairs. These exchanges are now a routine part of living donation. In 2024, 23.4 percent of living donor kidney transplants in the U.S. were performed through donor exchanges, according to the OPTN/SRTR 2024 Annual Data Report.
Some people also join an exchange even when they are compatible, because it can find a better-matched kidney for the recipient. Ask the transplant center which exchange programs it takes part in.
What Donation Involves for the Donor
Understanding what your donor will go through can make the conversation easier for both of you. The process has several parts.
Evaluation
The donor is evaluated by the transplant center with blood and urine tests, imaging of the kidneys, heart testing, cancer screening appropriate to their age, and a psychosocial review. The donor’s information is kept confidential from the recipient.
Federal rules also require transplant programs to provide an independent living donor advocate, someone who is not involved in the recipient’s care. The advocate’s job is to protect the donor’s interests and make sure the decision is informed and voluntary, without pressure from anyone, including family. A donor can decline or withdraw at any point, and the center does not have to tell the recipient why.
Surgery and Recovery
Most donor surgeries use minimally invasive laparoscopic techniques, performed through small incisions. UT Southwestern Medical Center reports that donors typically stay in the hospital about 24 to 48 hours and return to regular activities within four to six weeks, with many going back to work a week or two after that, depending on their job. After donating, donors are advised to see a primary care physician each year for blood pressure and lab checks, avoid nonsteroidal anti-inflammatory drugs (NSAIDs, such as ibuprofen and naproxen), and tell future providers that they have one kidney.
Risks to the Donor
Living donation is major surgery, and transplant centers are required to explain the risks in detail before anyone consents. Two numbers help put them in perspective:
- Surgical risk: a 2024 study in JAMA of 164,593 U.S. living kidney donors found that the risk of death within 90 days of surgery fell to 0.9 per 10,000 donations between 2013 and 2022.
- Long-term kidney failure risk: a 2014 study in JAMA estimated the lifetime risk of kidney failure at about 90 per 10,000 for donors, compared with about 14 per 10,000 for similarly healthy people who did not donate, and about 326 per 10,000 in the general population. The relative risk is higher, but the absolute risk remains low.
Individual risk varies with age, sex, race, blood pressure, weight, kidney function and whether the donor is related to the recipient, which is why each donor’s evaluation is personal. Donors are also counseled about other long-term considerations, including blood pressure and future pregnancy. These are questions for the donor to explore with the transplant center’s donor team.
Who Pays? Costs and Protections for Donors
A donor’s medical evaluation, surgery and related hospital care are usually covered by the recipient’s insurance, according to organdonor.gov. Donors can still face out-of-pocket costs such as travel, lodging and time away from work. Several programs help:
- National Living Donor Assistance Center (NLDAC): for eligible donors, NLDAC can reimburse travel, lodging, meals, lost wages and dependent care, up to $6,000 per donor-recipient pair. Eligibility depends mainly on the recipient’s household income, and the transplant center files the application.
- Texas state employees: Texas Government Code Section 661.916 allows up to 30 working days of leave in a fiscal year to serve as an organ donor.
- Federal employees: the U.S. Office of Personnel Management allows up to 30 days of paid leave each calendar year for organ donation.
- Other employers: the Family and Medical Leave Act may protect a donor’s job during recovery. Donors should check with their employer’s human resources team.
Federal law, the National Organ Transplant Act, prohibits buying or selling organs. A donor cannot be paid or given anything of value for a kidney, but reimbursement of legitimate expenses like those above is allowed. If you are unsure whether an offer of help is permitted, ask the transplant center before doing anything.
How to Talk to Someone About Living Donation
The hardest part of living donation is often the conversation itself. Many patients never ask anyone, because they worry about being a burden or damaging a relationship. Yet many donors say they were glad to be asked, or wished they had known sooner.
It can help to think of it as sharing your story rather than asking for a kidney. A few approaches patients use:
- Tell people close to you that you need a kidney transplant and that living donation is an option. Let them come to you.
- Ask a family member or friend to serve as your “champion,” someone who spreads the word on your behalf so you do not have to make every request yourself.
- Share the transplant center’s living donor contact information, so potential donors can ask questions privately and start screening on their own.
- Remind anyone who is interested that they can stop at any time, and that the center will keep their decision confidential.
Your nephrologist and the transplant center’s social worker can also help you plan what to say.
Living Donor Kidney Programs in the Fort Worth Area
Living donor transplants are performed at transplant centers, not at nephrology offices. In Fort Worth, programs with living donor services include Baylor Scott & White All Saints Medical Center and the Medical City Fort Worth Transplant Institute, with additional programs in Dallas. Each center sets its own donor criteria and schedules. Your nephrologist can help you decide which program fits your needs and insurance, and can make the referral. Programs are listed for information only and do not represent an endorsement.
For Referring Physicians: Start the Donor Conversation Early
Living donor transplant before dialysis gives patients the best chance at a scheduled, preemptive transplant, but it depends on time: donor evaluation alone can take weeks to months. Raising transplant, including living donation, with patients whose CKD is advancing lets them begin donor conversations before dialysis is needed. Primary care physicians, internists and cardiologists across Tarrant County can refer a patient to Fort Worth Renal Group online.
How Fort Worth Renal Group Supports Transplant Patients
Fort Worth Renal Group is an independent, renal-exclusive nephrology practice, built in Fort Worth, for Fort Worth. We do not perform transplant surgery. Our role is to prepare you for it and to care for you before and after. Your nephrologist helps you understand whether transplant is right for you, refers you for evaluation, works to keep you as healthy as possible while you wait, and coordinates with your transplant center. Our transplant care page describes that role, and our guides on preparing your body for transplant surgery and protecting your kidney long term cover what comes next.
Transplant is one option among several, and not every patient is a candidate. Your nephrologist will explain the benefits and risks of each choice in terms of your own health. The decision is yours.
One of our seven locations is likely close to your home: our main office on Windsor Place, Fort Worth Alliance, our NorthStar Clinic on South Hulen Street, North Richland Hills, Lake Worth, Burleson and Willow Park.
Frequently Asked Questions About Living Kidney Donors
What if asking someone damages our relationship?
It is a common fear, and a reasonable one. Sharing your situation instead of making a direct request takes pressure off both of you. Anyone who is interested can contact the transplant center privately, and if they decide not to donate or are ruled out, the center keeps that confidential. Many families find that talking openly brings them closer.
What if my donor has health problems later?
Donors are evaluated carefully to lower that chance, and they are counseled on how to protect their remaining kidney. If a prior living donor ever needs a kidney transplant, national transplant policy gives them priority on the waiting list. Donors should ask the transplant center to explain this and their long-term follow-up plan.
Can my donor change their mind?
Yes, at any point before surgery. The independent living donor advocate is there to make sure the choice stays voluntary, and the center does not have to share the donor’s reasons with you.
Does my donor have to pay for anything?
The donor’s evaluation and surgery are usually billed to the recipient’s insurance. Travel, lodging and lost wages may not be covered, although programs such as NLDAC can help eligible donors. The transplant center’s financial coordinator can walk through the details with both of you.
Can I pay or reward someone for donating?
No. Federal law prohibits giving anything of value in exchange for an organ. Reimbursing legitimate expenses, such as travel or lodging, through approved channels is allowed. Ask the transplant center before offering any kind of help.
I’m already on dialysis. Is it too late for a living donor?
No. Many people receive a living donor kidney after starting dialysis. Starting earlier has advantages, but being on dialysis does not rule you out.
What if I don’t have anyone who can donate?
You still have options. You can stay on the deceased donor waiting list, some people receive kidneys from non-directed donors, and a champion can help share your story more widely. Ask your nephrologist about getting on the transplant list as early as you are eligible.
Take the Next Step Toward a Transplant Conversation
Wondering whether a living donor transplant could be right for you? Schedule an appointment with our nephrology team today, or call us at 682-207-1700. Fort Worth Renal Group proudly serves patients throughout Fort Worth, Tarrant County, and the greater North Texas area, with our office located at 1902 Windsor Place in Fort Worth.
We don’t just treat kidney disease. We change what happens next.
Sources
- Health Resources and Services Administration. Organ Donation Statistics, organdonor.gov, accessed September 2026.
- United Network for Organ Sharing. U.S. surpasses 49,000 organ transplants while deceased organ donations dip, January 28, 2026.
- Scientific Registry of Transplant Recipients. OPTN/SRTR 2024 Annual Data Report: Kidney.
- JAMA. Thirty-Year Trends in Perioperative Mortality Risk for Living Kidney Donors, 2024.
- JAMA. Risk of End-Stage Renal Disease Following Live Kidney Donation (Muzaale et al.), 2014.
- Electronic Code of Federal Regulations. 42 CFR 482.98, Condition of participation: Human resources.
- National Living Donor Assistance Center. Frequently Asked Questions.
- Health Resources and Services Administration. Living Donation and Organ Donation Legislation History, organdonor.gov.
- UT Southwestern Medical Center. Kidney Donor Surgery and Recovery.
- Cleveland Clinic. Living Kidney Donation.
- Texas Government Code. Section 661.916, Leave for Organ or Bone Marrow Donors.
- U.S. Office of Personnel Management. Bone Marrow or Organ Donor Leave.
Medical and Educational Disclaimer
This article is provided for educational and informational purposes only and is not intended as medical advice, diagnosis, or treatment. Health information is general in nature and may not apply to your specific situation. Reading this article does not create a physician-patient relationship with Fort Worth Renal Group or any of its providers. Transplant centers are listed for informational purposes only and do not represent an endorsement or referral arrangement.
Always consult your physician, nephrologist, or other qualified healthcare provider regarding any questions you have about a medical condition or before making changes to your healthcare, medications, or lifestyle. Never delay or disregard professional medical advice because of information contained in this article. If you are having a medical emergency, call 911.
