NYU Langone Health wasn't always a pioneer in transplantation.
In recent years, the world's first pig-to-human kidney xenotransplant in a neurologically dead patient, combined mechanical heart pump and pig kidney transplant, whole-eye and partial face transplant and the nation's first fully robotic lung transplant all happened at NYU Langone — and not through luck.
Robert Montgomery, MD, PhD, director of the system's Transplant Institute, told Becker's the culture and institutional structure is the "magic" behind these several firsts in transplantation.
In 2015, NYU Langone Health CEO and dean of NYU Grossman School of Medicine, Robert Grossman, MD, asked Dr. Montgomery how to make transplantation a flagship enterprise. At the time, the transplant program was the second smallest of 15 programs in New York. He was also director of the Johns Hopkins Comprehensive Transplant Center.
The New York City-based system's transplant program was "very small" and "at the bottom of the state," he said, but "I felt that we could really develop the Institute … in a way that I wasn't able to do at Hopkins, and I didn't think [it] could be done at most institutions, because everybody would be worried about their own piece of the pie [budget]."
The opportunity he saw prompted him to leave Baltimore-based Johns Hopkins for NYU Langone in 2016.
Now, NYU Langone's liver, kidney and lung adult transplant programs are ranked No. 1 in New York, according to the Scientific Registry of Transplant Recipients. Its kidney transplant program for pediatric patients is also ranked the best in the state.
Volume rapidly grew, too, at the same time of an increase in quality and capacity for clinical trials, Dr. Montgomery said. About 70 faculty members and 150 nurse practitioners and staff work for the Transplant Institute.
He credited the successes to the organization's governance structure and institutional structure.
Unlike historical academic institutions, NYU Langone's hospital system and medical school are fully integrated: "There's sort of one pot of money that we all operate from, and so we're really incentivized to think in an institutional fashion, in a health system fashion, rather than to think about our own silos," Dr. Montgomery told Becker's.
"If you want to know what our superpower is and why we do the things that we do, I think it's that," he said of NYU Langone's integrated structure. "It's the 'why' of our ability to get behind an idea like xenotransplantation, to get behind an idea like face transplantation, and fully develop it as an institutional innovation or project rather than a departmental or some segment of the institution."
To sustain its growth, the organization is focused on connecting every employee's daily actions to each successful patient story. Dr. Montgomery also said his recruiting philosophy is hiring "luminaries in all different areas of transplantation."
"If you bring the best people together and give them the freedom to really spread their wings" and a "really clear culture that you can describe in a sentence," he said, "then you just let it happen. Don't get in the way of it."