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Mystery Surrounds Jobs' Liver Transplant

Wall Street Journal Note Wait Times Vary by State

By CANDICE CHOI
,
AP
posted: 143 DAYS 3 HOURS AGO
comments: 424
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NEW YORK (June 20) -- 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.
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.
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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."
The Journal reported that at least some Apple directors were aware of the surgery.
The Journal also reported that Jobs' transplant highlights how wait times vary from state to state. The Journal said that Jobs traveled to Tennessee for the operation. In 2006, the median wait for a liver transplant was 48 days in Tennessee -- compared to 306 nationally.
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.
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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.
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.
Copyright 2009 The Associated Press. The information contained in the AP news report may not be published, broadcast, rewritten or otherwise distributed without the prior written authority of The Associated Press. Active hyperlinks have been inserted by AOL.
2009-06-21 14:02:47

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TheFuzzyGiggler

04:50 PMJun 23 2009

God doesn't exist. I love AOL Trolls.

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homes4pandas

04:39 PMJun 23 2009

Too all the liberals who want everything given to everyone on the simple basis of " Well , we're all human beings ." That will never begin to pay the bills , medical or otherwise . Mr.Jobs has been an extrordinarily productive person providing employment for many and innovation not often paralleled in our time . Extending his life by any means available is no problem to me . His bills will , no doubt , be paid . Free medical services , like free advice , will degrade to like value , and , we know what free advise is most often worth , don't we . God bless you Steve Jobs . ( not an Apple user )

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kattykonk

03:56 PMJun 23 2009

With all of the money that he has...he probably bought the liver.

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(1)

BIG DOTTLE

10:37 AMJun 23 2009

Thank you Mc1954car for your kindness. My point was a transplant team somewhere has to approve you to go on the transplant list or you don't get on it. I don't know Mr. Jobs relatioship with his doctors so I can't say how he got on the list if thats the way he went. In my opinion (and we all know how opinion goes) my husbands drs. put him off so long and let him get so sick that his fate was set. Of the ever how many drs. make up a transplant team he only seen 2 of them the whole 2 1/2 years we went for medical treatment , those 2 drs. reported back to the other drs. and they make their decision to list or not to list. The way to the list is the drs. if they don't want you on it you don't get on it

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shaynafullarton

10:09 AMJun 23 2009

There are many medical advances that allow for living donors to provide liver tissue as well as taking from cadavers. How do we know he didn't have one of those procedures - he has every right to extend his life with these options.

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Hapj04

07:16 AMJun 23 2009

I have absolutely no problem with Steve getting what he needs no matrter how. He's got the money and any one of us would do the same. Anyone who has a problem with whatever Steve did to get his surgery needs to get over it. What better use of the money one has made in this life is better spent than tto save ones life? I wish Steve the best and the best of health - and would only ask him to strongly advocate for a single payer option in the upcoming battle for reformed healthcare for the rest of us.

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Cantillon1

05:49 AMJun 23 2009

HugsandSnuggles: if we have government health insurance, pharmaceutical companies won't bother to invent drugs like the one you seek because they will lose money on it. The cost of research and development is high because it takes a long time and big risks. This costs money.

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Scmedasst

05:49 AMJun 23 2009

In order to get a liver transplant there are many criteria, some of which have to do with being able to afford and comply with the treatment regimen of anti-rejection drugs for the rest of your life, having a good support system (homeless you can forget it pretty much.) History of alcohol abuse? you can forget it-you've already run through one liver, the likelihood of them giving you another one to ruin is small if not impossible. I have great insurance, it pays all but a tiny portion of my healthcare costs. If socialized healthcare comes to this country, why should my employer continue to provide it? Those of you whining for government healthcare need to realize that those expensive drugs you're whining about will most likely not be covered (many aren't in Canada and England) and you will have to come up with the $$ to pay for them even with socialized medicine. I pay a $10 copay for one med that isn't covered in Canada's system, in fact a friend in Canada with the same conditi...

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Cantillon1

05:43 AMJun 23 2009

Once the Democrats nationalize health insurance, only the cash paying rich will be able to obtain transplants after middle age. Look at Great Britain and Canada for examples of how the government rations healthcare. You have to wait for six months an appointment with a pediatrician for your children! People on the public health insurance are treated like sub humans. The rich pay cash and get great medical services from those medical practioners that don't participate in the government's plan. GOD HELP THIS COUNTRY!!!!!

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FamousBug

05:40 AMJun 23 2009

Life isn't fair. We live in a capitalistic society. So why be surprised or indignant? Everyone wants the opportunity to make money -- no matter what the outcome--this is part of the consequences. If Jobs was able to get a liver with money, so be it. Others buy a Hummer, Testarosa, or travel around the world. It is what it is. Nobody ever claimed USA was a fair society. It's never been about that.

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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.