Dr. Robert Montgomery experienced multiple cardiac arrests, heart failure, and a near-fatal episode in Patagonia before receiving a heart transplant in September 2018.
Hiking in Patagonia and the First Near-Fatal Cardiac Arrest in 2010
The first time Dr. Robert Montgomery went into cardiac arrest and died briefly, he was hiking in Patagonia near the southernmost tip of South America in 2010. He felt his racing heart as he lagged behind his son John and their guide before collapsing face down into the snow. An implantable cardioverter-defibrillator (ICD) in his chest delivered a shock that restored his heartbeat and saved his life.
At the time of this incident, Montgomery was 50 years old and leading one of America’s premier organ transplant centres at Johns Hopkins Medicine. He quickly recovered from the collapse, but the episode signaled the accelerated failure of his native heart. Heart transplants are rare, with only a few thousand people able to get a heart annually in the United States while some 50,000 organs are transplanted.
Growing Up with Dilated Cardiomyopathy and Family Tragedies
Montgomery’s career in medicine was shaped by a familial vulnerability to genetic heart disease. At age 14, his father developed symptoms of dilated cardiomyopathy, a rare condition that stretches and enlarges the heart’s chambers, leading to heart failure, dangerous arrhythmias, and sudden cardiac death. His father suffered severe brain damage from a cardiac arrest and died in 1976. Eleven years later, just after starting a surgical residency at Johns Hopkins Medicine, Montgomery learned his 35-year-old brother, Rich, had died suddenly while water-skiing from the same likely genetic mutation. Medical evaluations confirmed that Robert Montgomery carried the same condition.
Faced with a diagnosis that threatened his rigorous surgical training, Montgomery received an ICD to control his arrhythmias. Unsure if he could finish his residency, he moved to England to study immunology and earn a doctorate just in case surgery didn’t work out. He returned to Johns Hopkins in 1992 determined to specialize in transplant surgery, operating with a sense of urgency because he knew he would eventually require a heart transplant himself.
Innovations in Kidney Exchanges and Domino Donations at Johns Hopkins
Because heart transplants were scarce in the early 1990s, Montgomery focused his clinical energy on kidneys, the most frequently transplanted organ. At Johns Hopkins, he helped pioneer a minimally invasive technique to retrieve kidneys from living donors, which boosted participation rates. In 2001, he established a program designed to match incompatible donor-recipient pairs.
By this time, his personal cardiac episodes had escalated. In 2017, he returned to Patagonia with his sons, where he suffered another cardiac arrest far from any hospital. His son John performed chest compressions in a moving Jeep during an emergency transfer. Montgomery subsequently spent over a month in a medically induced coma in New York, relearning how to walk, talk, and eat.
Receiving a Hepatitis C-Positive Donor Heart in September 2018
Following his return to New York, Montgomery suffered additional cardiac arrests, including one in the middle of a Broadway performance of School of Rock and four successive cardiac arrests during a medical conference in Italy in September 2018. These recurring medical crises finally qualified him to join the waiting list for a heart.
On September 20, 2018, Montgomery accepted a donor heart from an individual who had died of a heroin overdose and was infected with hepatitis C. While colleagues questioned the safety of utilizing an infected organ in a newly established program, Montgomery moved forward with the surgery. He would be part of a clinical trial if he received one.
Pioneering Genetically Modified Pig Organ Transplants at NYU Langone
He turned his focus toward xenotransplantation—transplanting organs from animals into humans.
Montgomery played a leading role in the use of organs from genetically modified pigs. Last year, the US Food and Drug Administration authorized clinical trials for pig organ transplants in critically ill patients who lack other treatment options, with Montgomery leading two of them.
Frequently Asked Questions About Dr. Robert Montgomery and Xenotransplantation
Why did Dr. Robert Montgomery need a heart transplant?
Dr. Robert Montgomery suffered from dilated cardiomyopathy, a rare genetic heart muscle disease that caused his heart chambers to enlarge and led to recurrent, life-threatening cardiac arrests. The condition also caused the deaths of his father in 1976 and his brother Rich.
What was unusual about the human heart Dr. Montgomery received in 2018?
The donor heart Dr. Montgomery received on September 20, 2018, came from an individual who had died of a heroin overdose and carried a hepatitis C infection.
What is xenotransplantation and how does it relate to Dr. Montgomery’s recent work?
Xenotransplantation involves transplanting animal organs into humans. Dr. Montgomery played a leading role in the use of organs from genetically modified pigs and now leads US Food and Drug Administration-approved clinical trials evaluating pig organs for patients.
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