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pink pig with black spots looks out of a metal bucket

Robert Montgomery walked deliberately down the hospital hallway carrying a stainless-steel bowl containing a living human kidney resting on a bed of ice. Minutes earlier the organ had been in one man's body. It was about to be implanted into another man to keep him alive.

It was about 11 A.M. on a Monday this past spring. I followed Montgomery, an abdominal transplant surgeon and director of the NYU Langone Transplant Institute, into an operating room where 49-year-old John Primavera was waiting to receive the precious kidney. Monitors beeped; Shakira played on the sound system. Montgomery, who has performed thousands of transplants, walked up to the operating table and gently lowered the organ into Primavera's abdomen. The kidney, offered to Primavera by his close friend Thomas Kenny, was pale and about the size and shape of a mango. Montgomery motioned for me to step toward the table. I watched as he removed the clamps on the artery he had just sewn onto the replacement organ. The kidney flushed pink with blood and began to pulse with life.

This kidney transplant...