Robert Montgomery, MD, DPhil, a pioneer and leader in transplantation surgery, was awarded the Jacobson Innovation Award by the American College of Surgeons, the nation’s preeminent organization dedicated to setting the standard for surgical care. He was recognized for his pioneering efforts in paired kidney donations and for leading the world’s first successful pig-to-human kidney xenotransplant.
Dr. Montgomery, the H. Leon Pachter, MD, Professor of Surgery, chair of the Department of Surgery, and director of the NYU Langone Transplant Institute, was the 30th recipient of the award, which acknowledges surgeons who have innovated a new development or technique in any surgical discipline.
“There are few greater honors than to be recognized by this tremendous body of peers,” said Dr. Montgomery. “There are so many luminaries in this community of surgeons, and it’s truly a privilege to be in the company of so many expanding the boundaries of surgery to help our patients in need.”
A Life of Innovation
Dr. Montgomery started his surgical career as an innovator, though in atypical fashion. After completing his medical degree at the University of Rochester School of Medicine, he went on to surgical residency at Johns Hopkins University where, in 1989, he became the first practicing surgeon in the world to receive an implantable cardiac defibrillator. Both he and two of his older brothers, one who died of a cardiac arrest at 35 and another who received a heart transplant at 39, inherited a rare form of heart disease from their father, who died when Dr. Montgomery was just a teenager.
He was given the opportunity to take a break from the operating room and pursue a doctorate in molecular immunology at the University of Oxford’s Balliol College. He returned to Johns Hopkins in 1992 to complete his general surgery training, a fellowship in multiorgan transplantation, and a postdoctoral fellowship in human molecular genetics. During his fellowship, Dr. Montgomery was part of the team that developed the laparoscopic kidney procurement technique that is now the global standard.
In 2009, as director of the Johns Hopkins Comprehensive Transplant Center, in Baltimore, Dr. Montgomery was the first surgeon to conceive of the “domino kidney transplant” procedure, and the first to lead it. This culminated in eight donors with incompatible recipients across four different states, giving their organs to strangers so their loved ones could receive a compatible organ.
Dr. Montgomery completed numerous domino pair procedures over 20 years at Johns Hopkins, including a 10-way kidney donation-chain procedure that started with an altruistic donor. The “domino kidney transplant” procedure has been scaled up by the National Kidney Registry and is responsible for 1,500 living donor transplants annually that would not have occurred otherwise.
In 2018, due to his deteriorating heart condition, called familial dilated cardiomyopathy, he experienced a series of cardiac arrests while abroad at a medical conference. After four similar episodes over his three decades since receiving a defibrillator, he underwent a heart transplant, volunteering to be a participant in an experimental protocol to receive a hepatitis C–positive heart at NYU Langone Health from a drug overdose victim—a concept and procedure that his team had developed.
Fixing a Broken Paradigm
After joining NYU Langone in 2016 as director of its Transplant Institute, Dr. Montgomery expanded transplant services, increasing volume across all organ groups while earning top quality ratings. He led the creation of heart and lung transplant programs, as well as pediatric kidney, heart, lung, and liver programs, and an expansion of the allogeneic bone marrow transplant program.
Informed by his own experience of waiting for a heart, and knowing that the odds of receiving one were remote due to the scarcity of organs, he became dedicated to identifying a new source of renewable, unlimited organs. In 2021, he led the world’s first successful investigational pig-to-human kidney xenotransplant in a neurologically deceased recipient, a breakthrough that demonstrated genetically engineered pig organs could potentially serve as a solution to the critical shortage of human organs available for transplant.
Three years later, Dr. Montgomery led the team in performing the first combined mechanical heart pump and pig kidney transplant surgery in a 54-year-old woman with heart and kidney failure. She was the first female, and only second patient in the world, to receive a genetically engineered pig kidney transplant.
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Colin DeVries
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