June 22, 2009 -- The Wall Street Journal reports that Steve Jobs, Apple's chief executive officer, had a liver transplant in Tennessee about two months ago.
The report has raised questions about Jobs' health.
Apple didn't reply to queries from WebMD about Jobs' reported liver transplant. The Wall Street Journal quotes an Apple spokeswoman as saying that Jobs looks forward to returning to work at the end of June. Her statement didn't confirm or deny a liver transplant.
Jobs hasn't revealed many details about his health over the years. But he has acknowledged having surgery in 2004 to remove a pancreatic tumor, which he called a very rare form of pancreatic cancer called an islet cell neuroendocrine tumor.
On Jan. 5, 2009, Jobs posted a letter on the Apple web site stating that he was being treated for a "hormonal imbalance," but he didn't specify what hormones were involved or whether the problem was linked to his previous pancreatic cancer.
On Jan. 14, 2009, Jobs announced that he would take a medical leave of absence until the end of June from his role as Apple's chief executive officer in order to focus on his health. In a letter posted on Apple's web site, Jobs said he'd learned that "my health-related issues are more complex than I originally thought," but he provided no details about his condition.
For insight into Jobs' reported liver transplant, WebMD spoke with liver transplant surgeon Ari Cohen, MD, of the Ochsner Clinic Foundation in New Orleans and Abhi Humar, MD, clinical director of the Thomas E. Starzl Transplantation Institute at the University of Pittsburgh Medical Center. Neither doctor is treating Jobs.
Both doctors agree that islet cell tumors -- the type of tumor Jobs had removed in 2004 -- can spread to the liver.
"If they're to spread, that's probably one of the most common places where they do spread," Humar says.
Humar says when those tumors spread to the liver, they can be surgically removed, "but if they've spread to multiple places in the liver, then the liver transplant is an accepted form of treatment for that."
Cohen says that a liver transplant would usually only be done after other treatments -- including chemotherapy and repeated surgeries -- fail.
Humar says chemotherapy doesn't have good response rates for this type of tumor. "It isn't a good option, but it's an option," Cohen counters. "He's correct, but it's still offered to some patients."
Surgeons can transplant a whole liver from a deceased donor or part of a liver from a living donor. The Wall Street Journal didn't report details about Jobs' liver donor.
Shortage of Liver Donors
There are many more people awaiting liver transplants than there are donated livers. "That's probably the biggest challenge," Cohen says.