Kyle Froelich’s first search for a donor kidney ended in a fairy tale romance.

In 2010, Chelsea Clair decided to give her kidney to Froelich—a man she’d never met—after hearing through a mutual friend that both of his were failing. The pair began seeing each other every day as Clair went through the donor testing process and eventually started dating after the transplant was complete. Kyle’s health returned, and they got married three years later, making headlines across the country.

Now, however, the Indiana couple is back in the news for a less celebratory reason: the kidney Chelsea donated is failing. If Kyle doesn’t get a new one within the next year, he says, he’ll be forced to go on dialysis.

“We’ve done it before. You have to stay optimistic,” Kyle, 28, says of his second search. “I don’t ever worry about it. I just have faith that it’s going to happen. When it happens, it happens.”

The first time around, it happened thanks to Chelsea.

At age 12, Kyle was diagnosed with a condition that causes an antibody to collect in his kidneys, resulting in inflammation that makes it difficult for his organs to filter waste products from his blood. By 19, Kyle was in desperate need of a transplant. He began looking for a donor among family and friends, but his type O blood made it difficult to find the right match. Dozens of his loved ones were tested, but none was the right fit.

“I’d had so many people tell me that they wanted to do it,” he says, “and it was for a long time a letdown, because nobody was ever a match.”

Then along came Chelsea, who heard about Kyle when a mutual family friend asked her to hand out flyers for a fundraiser on his behalf. The more she learned, the more she wanted to help.

“My dad needed a bone marrow transplant back in 2006 [but] he passed away before it could happen,” says Chelsea, who is now 31. “When I learned about Kyle, it was kind of like our situation. I just had this feeling that maybe I could be the one that helped.”

Today, the Froelichs are parents to a six-year-old son, as well as Chelsea’s 12-year-old daughter from a previous relationship. “When somebody saves your life, you want them in your life forever,” Kyle says.

But nearly 10 years later, they’ve found themselves right back where they started: searching for a kidney for Kyle, after a bout of pneumonia weakened his immune system and allowed his underlying condition to worsen, pushing him toward kidney failure and leaving him to battle through near-constant fatigue, nausea and weakness.

“It’s definitely different than the first time, when he was younger and didn’t have any children or responsibilities like that. It’s scary,” Chelsea says. “But I’m hopeful.”

Dr. Tim Taber, Kyle’s nephrologist at Indiana University Health (IUH), says it’s not uncommon for kidney recipients to need a second, or even third, transplant. But Kyle’s kidney failure happened “a little sooner than we expected for him,” Taber says.

Taber says they’ll start by looking for a donor match for Kyle, though that may be difficult, since Kyle already knows that most of his loved ones are not matches. The couple is relying on flyers and word-of-mouth awareness, as well as a February Today show appearance that they say resulted in hundreds of messages from people who said they wanted to get tested.

“Getting his story out there certainly raises the chances that he’s going to find a donor,” Taber says. But if he doesn’t, IUH may resort to paired donation, in which patients with willing but unsuitable donors are paired up with other patients in that position, in hopes that their potential donors are matches for each other.

Kyle is also on the national organ waiting list. But with more than 100,000 Americans in need of kidneys, according to the National Kidney Foundation, Taber says the wait time for one in Indiana is between three and six years — time that Kyle doesn’t have. With few other options, the Froelichs are doing everything they can to find a kidney on their own.

“You’re never done looking until you’re on the table for surgery,” Kyle says. “There are so many things that can go wrong and change. That’s why it was such a big deal when Chelsea was a match the first time.”

The kidney transplant was “not what our relationship was founded on or built on, but we would have never met each other if that hadn’t happened,” he says. “It’s kind of sad and surreal that at some point in the future, that’s going to come to an end.”

If you’re interested in donating a kidney to Kyle, learn more and contact Indiana University Health here. If you’re interested in organ donation in general, learn more through the United Network for Sharing Organs.

Write to Jamie Ducharme at jamie.ducharme@time.com.