Questions Over Steve Jobs' Liver Transplant

Jun 25, 2009 11:39 am US/Pacific

Questions Over Steve Jobs' Liver Transplant

Reporting
Dr. Kim Mulvihill, M.D.
E-mail
(CBS 5)

It's been hard to decipher what's exactly going on with Steve Jobs and his health. He's given scant information and few details.

On January 5th, 2009, Jobs wrote that he had been losing weight throughout 2008 and that the cause was a mystery to him and his doctors.

He then noted that his doctors believed the cause was a hormone imbalance. One week later, on January 14th, Jobs announced that the health related issues were "more complex" than he originally thought; that he intended to take a medical leave of absence but that he intended to return to the company at the end of June.

While Jobs' description of his health problems sound vague, his view on death is not. During a commencement address in 2005, in front of Stanford graduates, Jobs noted how "No one wants to die. Even people who want to go to heaven don't want to die to get there."

With that in mind, we now know Jobs went to Memphis, reportedly bought a mansion in an exclusive enclave close to Methodist University hospital, where he underwent a liver transplant. The hospital confirmed the surgery but gave few details, citing patient privacy. We don't know the precise reason why he needed the transplant.

But first, some more background:

In 2004, Jobs had surgery in the Bay Area for a rare form of pancreatic cancer. He was diagnosed with a neuroendocrine tumor, which is slow growing. This kind of tumor can spread to the liver. We don't know whether this has indeed happened to Mr. Jobs, but we do know that he did get a liver transplant.

But why would Jobs, with top notch transplant centers in his own backyard, go all the way to Tennessee?

UC Medical Center's Dr. John Roberts has an idea. Dr. Roberts is head of transplant services at UCSF whose specialty is liver and kidney transplants.

He believes Mr. Jobs is a very savvy consumer of health care. Dr. Roberts adds that he counsels transplant patients to look outside the Bay Area and California as they wait for a liver.

Why? Better odds.

Organs are divvied up according to region and a priority score called MELD. MELD is a numerical measure used by transplant centers to assess the severity of a patient's liver disease. In San Francisco and the Bay Area, most transplant patients have a MELD score of 30. That means you have a high probability of dying in 3 months. Other regions of the country, you may find transplant centers that transplant livers into patients with lower MELD scores.

Methodist hospital says Jobs had the highest MELD score for his blood type, and therefore, was the sickest patient on their waiting list at that time when the liver came up. But according to the United Network for Organ Sharing or UNOS, nearly 69% of liver transplants done at Methodist occurred in patients with a MELD score of 20 and under. According to Dr. Roberts, a MELD score of 20 means your risk of dying within 3 months is under 10%. Dr. Roberts says its best to undergo a liver transplant when your score is lower, because you'll do better afterwards and it will take a shorter time to recover. It makes sense.

But even if Methodist Hospital says Jobs was the sickest patient at that time, that does not mean Jobs was the sickest patient in the nation. It's important to note that we have no access to his actual MELD score.

However, Jobs may just be a thoughtful consumer who did his homework and who understood what it took to go and get a transplant.

Dr. Robert says any patient can register at multiple transplant centers across the country.

But that takes time, money, good health insurance and family support. Dr. Roberts believes the system needs a change, and that organs should be available to the sickest patient nationwide. In addition, we can also use more organ donations. More than 15,000 patients are waiting for a liver transplant. Thousands will die waiting.

Dr. Roberts says that there are other patients who may not have the same abilities that Mr. Jobs has and "that for those patients we should consider bringing the organs to the patients rather than having the patients have to travel across the country to get a transplant."

Related Stories

* Apple's Jobs Taking Medical Leave, Shares Tumble
(1/15/2009)
* Apple's Jobs Has Hormone Imbalance, Will Stay CEO
(1/6/2009)
* Steve Jobs Dismisses Health Rumors At SF Event
(9/9/2008)

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