Sunday, June 21, 2009

Apple CEO Steve Jobs had liver transplant

Apple Inc. co-founder and CEO Steve Jobs, whose recovery from pancreatic cancer appeared less certain when he had to take medical leave in January, received a liver transplant two months ago but is recovering well, The Wall Street Journal reported Saturday.


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The newspaper didn't reveal a source for the report, which comes as Jobs, 54, is expected back in his day-to-day duties at the company shortly. CNBC said later that it had confirmed the Journal's account, which said Jobs had the transplant performed in Tennessee.

Apple spokesman Steve Dowling told The Associated Press he had no comment. Dowling reiterated what has become Apple's standard line about the CEO's health, that "Steve continues to look forward to returning to Apple at the end of June and there is nothing further to say."

Few CEOs are considered as instrumental to their companies as Jobs has been to Apple since he returned in 1997 after a 12-year hiatus. With Jobs serving as head showman and demanding elegance in product design, Apple has expanded from a niche computer maker to become the dominant producer of portable music players and a huge player in the cell phone business. News and rumors about his health send Apple stock soaring or plunging.

Jobs disclosed in August 2004 that he had been diagnosed with — and cured of — a rare form of pancreatic cancer called an islet cell neuroendocrine tumor.

According to the National Institutes of Health, treatment for that form of pancreatic cancer can include the removal of a portion of the liver if the cancer spreads. The cancer is curable if the tumors are removed before they spread to other organs.

It's likely that Jobs had part or all of his pancreas removed to "cure" his cancer in 2004, said Dr. Lewis Teperman, vice chair of surgery and director of transplantation at NYU Langone Medical Center in New York City.

Patients who have part or all of their pancreas removed usually get diabetes, which is treated with medication. Patients often lose weight as a result as well.

After the pancreas, the liver is the "next stop" for a tumor since blood drains from the one organ to the other, said Teperman, who did not treat Jobs.

Since the type of pancreatic cancer Jobs had is "slow growing," it's likely microscopic cells went undetected and traveled to the liver, Teperman said. Tumors often "stop" at the liver, he said, although it's possible they can spread beyond it.

The risk for liver cancer patients who get transplants is that the cancer will return in the new liver.

This can happen if undetected cancer cells are hiding out elsewhere in the body, Teperman said. He said there's no way to predict the likelihood of this occurring without knowing the extent of the initial cancer.


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The five-year survival rate for organ transplants is around 75 percent, but falls among older recipients, according to the United Network for Organ Sharing, which manages transplants in the U.S.

Transplant patients must take medications for the rest of their lives to prevent rejection.

Since there is no residency requirement for transplants, Jobs might have traveled to Tennessee to shorten his wait for a liver. According to the organ network, there were 295 newly listed patients in Tennessee last year and 1,615 in California.

Wait times for transplants depend on the urgency of the patient's condition. Those in most critical need generally get transplanted within 10 days regardless of geography, said Joel Newman, a UNOS spokesman.

For less urgent cases, however, he said there's a greater variance in wait times, depending on a person's location.

Shorter waiting lists aren't the only reason to travel for a transplant, however.

"A lot of people who travel for a transplant will look at the center's survival rate or whether it specializes in certain conditions," Newman said.

Jobs' gaunt appearance last year fueled speculation that his health was worsening.

On Jan. 5 of this year, he said he had a treatable hormone imbalance and that he would continue to run the company. The following week, however, Jobs went on leave and said his medical problems were "more complex" than he had thought. Apple's chief operating officer, Tim Cook, took over daily duties.

Speculation about Jobs' health has been fueled by the Cupertino, Calif.-based company's practice of keeping such information under wraps.

Apple waited until after Jobs underwent his cancer surgery in 2004 before alerting investors. Last summer, the company insisted his thinner appearance was due to a common bug.

After Apple announced Jobs' medical leave in January, the company's shares slid 7 percent to $79.15, near a 52-week low. Since then, however, as Apple's business has remained sturdy even in the recession, and investors have become comfortable with Cook leading the daily operations, Apple shares have been among the best performers in the technology sector. The stock closed Friday at $139.48.

Jobs earned his status as a computing pioneer in 1976, when he and Steve Wozniak founded Apple in the Silicon Valley garage of Jobs' parents. Their first product, the Apple I, was a computer for hobbyists — it lacked a keyboard or monitor. But the next year they produced the Apple II for everyday consumers, and the personal-computer era was born.

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