Why Selena Gomez Needed a Kidney Transplant to Treat Her Lupus

Selena Gomez shocked her fans this morning when she revealed on Instagram that she underwent a kidney transplant over the summer. Now, many are wondering what this means for the singer’s current and long-term health.

The 25-year-old has been open about her battle with lupus for several years, first revealing in 2015 that she’d undergone chemotherapy to treat the disease. After taking time off to deal with anxiety and depression related to her condition, Gomez said in 2016 that she’s “very healthy.” So does the fact that she needed a kidney transplant mean she’s sicker than she let on?

Probably not, says Robert Montgomery, MD, director of the Transplant Institute at NYU Langone Health. Dr. Montgomery has not treated Gomez, but he does specialize in transplants for people with immune diseases including lupus.

While the private details of Gomez’s condition are unknown, Dr. Montgomery says that it’s common for lupus to damage kidneys to the point where one or both need to be replaced. “Not every patient who gets lupus ends up with kidney failure, but some do,” he says.

That’s because lupus, which causes the immune system to attack its own organs and tissues, can affect the whole body. According to the Lupus Foundation of America, about half of all cases of systemic lupus affect a major organ such as the heart, lung, kidneys or brain.

Because of that, many lupus patients will eventually need transplants to replace kidneys that have been damaged over time — especially because it can take years for the disease to be diagnosed and properly treated. Often, patients are added to a waiting list to be matched with a deceased donor, and they may have to go on dialysis for kidney failure while they wait months or even years.

But if a patient has a friend or family member who’s willing to be a live donor, they can schedule a preemptive kidney transplant before dialysis is needed. (Gomez’s living donor was her long-time friend and actress Francia Raisa.)

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The good news? “Generally doctors won’t do a kidney transplant until a patient’s lupus is in remission,” says Dr. Montgomery. “In this case, it sounds like she was treated a few years ago and now her lupus is under good control, or else they wouldn’t have done the operation.”

Lupus flares can still occur once a patient goes into remission, but for the most part, says Dr. Montgomery, “patients can lead a totally normal life.” Kidney-transplant recipients do have to take immunosuppressant drugs for the rest of their lives — but these drugs are much safer than they used to be, he adds, “and they can actually help keep lupus at bay.”

The fact that Gomez received a kidney from a live donor is good news for her health, as well.

“Live donor transplants last twice as long, on average, as deceased donor kidneys,” says Dr. Montgomery. “Young people who get a kidney transplant often need another transplant at some point in their lives, but if you want to get the most years out of the first kidney, a live donor is a great advantage.”

Dr. Montgomery says the recovery time from a kidney transplant is usually about six weeks for the recipient, and even less for the donor. “People can go back to their normal lives pretty rapidly, whether that’s going on tour or whatever they were doing before, and their outcomes are really very good.”