28 April 2022

On the black bench…

In Sweden, the star of transplantology, famous for tracheal transplantation, is being judged

Novye Izvestia according to the Guardian: 
Surgeon on trial in Sweden over experimental windpipe transplants (In Sweden, a surgeon is being tried for experimental tracheal transplants)
With the subtitle "Paolo Macchiarini, popularizer of pioneering surgery, charged with aggravated assault" – WM.


The first transplant was made to an African student living in Ireland – Macchiarini transplanted a patient's trachea grown in the laboratory from his own stem cells. In October of the same year, Macchiarini operated on a second patient, an American, at the Karolinska Institute in Stockholm. The doctor's work was regarded in the world as a breakthrough in regenerative medicine.

However, three years later, the staff of the Karolinska Institute initiated a scientific investigation, suspecting a colleague that he embellishes his own achievements in his articles, while his patients die one by one. As a result of the investigation, which turned into a criminal case five years later, it turned out that Dr. Macchiarini had been engaged in fraud of various kinds for many years. For example, he distorted his scientific biography in order to get a professorship at the Karolinska Institute, attributing positions to himself in various institutes, and repeatedly falsified facts in scientific articles. In addition, he lied to his patients, persuading them to agree to an operation that was not urgently needed.

But the most important thing is that he transplanted his bioengineered tracheas, not only without experimental confirmation of their safety for humans, but without even conducting experiments on animals. As a result, six of his eight patients who were tracked down in Sweden, operated on between 2011 and 2014, died shortly after surgery. Although an external audit in 2015 found Macchiarini guilty of misconduct in the field of research, and he had to be fired, nevertheless, the Karolinska Institute defended him until 2018, when the doctors were found guilty. In the same year, due to the scandal, the director of the institute resigned, and the Lancet medical journal withdrew two articles written by Macchiarini. The high-profile story, which lasted for several years, not only undermined the reputation of the Karolinska Institute, but also raised the question of how an essentially random person could be allowed to conduct such responsible operations in such a reputable scientific institution.

It is not known exactly how many people died after Macchiarini's operations in Russia, where he operated in the 2010s: in 2017, Roszdravnadzor refused the journalists' demands to report the number of patients of the doctor, citing medical secrecy. According to some reports, there were five such operations. For the first time, Macchiarini visited Russia in 2010, holding a master class on regenerative medicine in the building of the Presidium of the Russian Academy of Medical Sciences and reading a lecture "Bionics in Medicine of the Future" to students of the Sechenov Medical Academy. The following year, Macchiarini received an unprecedented large grant of 150 million rubles in Russia and created a laboratory of regenerative medicine on the basis of the Kuban State Medical University.

In 2012, Macchiarini operated in Krasnodar on a young Russian woman, Yulia Tuulik, who suffered a serious accident and lived with a tracheostomy. A year and a half later, the patient died. The girl's relatives told REN TV in an interview that she had been dying for a long time and painfully: "We thought that this was it, finally, finally everything turned out, thank God. And then she started coughing and spitting out pieces of meat with blue threads. There, apparently, it all decomposed... It's terrible, she collected these pieces of meat, put them in a "kinder surprise"." At the same time, experts expressed the opinion that Yulia Tuulik would have lived for many more years without surgery. The press service of the Krasnodar Medical University and the local Clinical Hospital No. 1, where the operation was performed, called all the accusations groundless.

In 2016, Macchiarini received a grant from the Russian Science Foundation to conduct preclinical studies of tissue engineering of the esophagus, as well as a position as head of the laboratory "Bioengineering and Regenerative Medicine" at Kazan University. In the same year, when a criminal trial had already begun in Sweden accusing Macchiarini of unintentional murder of patients, the doctors of the Karolinska Institute sent a letter to the Russian ambassador to Sweden and the Russian competent authorities demanding to investigate the doctor's activities in Russia. The Center for Anti-Corruption Policy of the Yabloko party, in turn, demanded to check the expenditure of funds on the megagrant received by the doctor. In 2017, Macchiarini left the university and Russia.

Now experts in the field of bioethics call Macchiarini's activities "ethical Chernobyl". At the trial, which is being held in Stockholm, the doctor was charged with aggravated physical assault on three patients. "Macchiarini carried out the operations with complete disregard for science and proven experience," Prosecutor Karin Lundström–Krohn told the court.

Dr. Macchiarini himself denies all charges, claiming that the operations were a treatment, not an experiment. "He believes that he provided medical assistance, treated and helped," said Macchiarini's lawyer Bjorn Hurtig, who also expressed hope that the defenders would be able to refute the prosecution's evidence.

The trial should last 13 days.

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