The Transplant Surgeon Who Needed a Heart Himself
Dr Robert Montgomery collapsed face down into the snow in Patagonia after a medical device implanted in his chest delivered a shock. It was 2010, and Montgomery was 50 years old, leading one of America’s premier organ transplant centers at Johns Hopkins Medicine.
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Key Clinical Takeaways:
- Dr Robert Montgomery experienced his first cardiac arrest in 2010 in Patagonia, followed by a second cardiac arrest in the exact same location in 2017.
- Both Montgomery’s father and his brother Rich died from dilated cardiomyopathy, a rare genetic condition that causes the heart’s chambers to stretch and enlarge.
- Approximately 660 people are currently waiting for an organ transplant in Ireland, including six patients waiting specifically for a heart transplant.
The Genetic Diagnosis That Threatened a Surgical Career
Montgomery first learned he needed a heart transplant while managing a failing heart of his own. As a child at age 14, he watched his father develop dilated cardiomyopathy, a rare disease leading to heart failure, arrhythmias, and sudden death, which ultimately required a feeding tube after brain damage from a cardiac arrest. By the time his father died in 1976, Montgomery had decided to become a doctor. Eleven years later, during his surgical residency at Johns Hopkins Medicine, his 35-year-old brother Rich died suddenly of the same condition, caused by a genetic mutation. Evaluations confirmed Montgomery carried the identical mutation, placing his rigorous surgical career in immediate jeopardy.
Managing Arrhythmia and Pivoting to Transplant Surgery
When medication failed to control his dangerous heart rhythms, Montgomery opted for an implantable cardioverter-defibrillator, or ICD, to shock his heart back into a normal rhythm. Unsure if he could finish his demanding residency, he and his wife temporarily moved to England to study immunology and pursue a doctorate as a backup plan. Returning to Johns Hopkins in 1992, Montgomery sought to specialize in transplant surgery precisely because of his personal diagnosis. Knowing he faced a shortened lifespan without a donor heart, he worked with intense focus.
Transforming Kidney Transplants Through Innovation
Because heart transplants were rare in the early 1990s, Montgomery concentrated on kidneys, the most frequently transplanted organ. At Johns Hopkins, he helped develop a minimally invasive surgical technique for retrieving kidneys from healthy living donors, significantly boosting donation rates. In 2001, he established a program to swap kidneys between incompatible donor-recipient pairs, pioneering domino donations where an altruistic donor gave a kidney to a stranger to trigger a chain of compatible swaps.
Relocating to NYU Langone Health Amid Ongoing Cardiac Risk
NYU Langone Health recruited Montgomery in 2016 to build a new organ transplant program, prompting his move to Manhattan with his wife, opera singer Denyce Graves, and their daughter. Despite his prior near-death experience in Patagonia in 2010, Montgomery returned to the same region in 2017 to spend time with his sons John and Max, only to suffer a second cardiac arrest.