The Heart of the Matter

Mark Mende

Dr. Robert Montgomery ’82 is the second Montgomery to receive a heart transplant; his brother, Larry ’78, received one as well. Unfortunately, it took his father dying at 52 and his older brother Rich ’74 passing at 35, for the family to discover there was a genetic link to cardiomyopathy, a disease that affects the electrical pathways of the heart muscle.

“We didn’t know at the time that this was something that was passed on,” says Montgomery. “It wasn’t clear it was a genetic disorder until Rich died, which led to the discovery of the gene affecting his family and inspired him to help start the Montgomery Heart Foundation for Cardiomyopathy.

“When my dad got sick, transplants were in their infancy. All those things must have been in my sub-conscious as I went through my studies,” he says. “I was going to be a veterinarian, but I gravitated towards taking care of people.” 

At St. Lawrence, faculty helped foster Montgomery’s interest in medicine, and he also learned the important people skills he would need in his future practice.

“There were people who had a big influence on me: Dana Professor Emeritus of Biology David Hornung and Professor Emeritus of Biology Tom Budd, to name a few,” he says. “They really nurtured my interest in science and medicine.” 

At St. Lawrence, Bob was awarded the Thomas J. Watson Fellowship to conduct medical research in Africa the year after he graduated. Then it was on to the University of Rochester for his medical degree and Oxford, on a Fulbright Scholarship, for his doctorate. He was already on a path to a career in medicine when the genetic link to his family’s heart issues was discovered.

At 29, Montgomery had to have a defibrillator implanted, and, at the time, he was unsure if he would be able to become a surgeon. But that is exactly what he did. In 1987, he began working at Johns Hopkins Hospital and School of Medicine in numerous capacities of increasing responsibility before moving to NYU Medical, where, in July 2020, Montgomery was named chair of the Department of Surgery at New York University Langone Health. Along with his new title, Montgomery continues in his role as director of the NYU Langone Transplant Institute, where he has been innovating new transplant treatments since 2016.

The work includes innovations on kidney transplantation for highly sensitized and blood-type incompatible patients. Montgomery came up with the concept of kidney paired donation chains in which patients with donors who are incompatible by blood type or tissue exchange kidneys so everyone gets a compatible organ. This innovation is responsible for 1,000 kidney transplants every year that would not have occurred otherwise. He was also part of the team that invented a new way to remove kidneys from living donors using minimally invasive techniques. He has traveled the world, helping to teach doctors how to use these new techniques and technologies. 

Montgomery’s medical career has taken a number of twists and turns, but like the circulatory system that he has devoted his life to treating, his journey always returns to the heart of the matter, quite literally. One of his innovations has been the development of protocols that allow hearts that are positive for hepatitis C to be transplanted into donor recipients. 

In this case, he is a doctor who stands by his work. Under the care of his team at NYU, in 2018, Montgomery himself was the recipient of a heart transplanted from a hepatitis C donor with a history of heroin addiction who died of an overdose. Today, he is doing well and is HCV free. 

Throughout his career, Montgomery has been generous in sharing his expertise and insights as a mentor to the next generation of St. Lawrence students. Many have had the opportunity to shadow Montgomery in his work. Some student mentees, like Morgan O’Hare ’16, share similar interests rooted in personal health challenges. O’Hare was diagnosed with a rare form of childhood cancer of the eye, which led her to follow a path into medicine, having benefited from shadowing Montgomery while he was at Johns Hopkins. 

For Montgomery, staying close to the Laurentian family is easy. His older brother, Rich, was a fraternity brother of President William L. Fox ’75, and “Foxy” as the family calls him, has remained close to the family. “Foxy spoke at my wedding,” Montgomery adds. “He’s a great family friend.” It is one of the many reasons that St. Lawrence remains close to his heart.