Intended for healthcare professionals


Disgraced tracheal transplant surgeon is handed 16 month prison sentence in Italy

BMJ 2019; 367 doi: (Published 25 November 2019) Cite this as: BMJ 2019;367:l6676
  1. Michael Day
  1. London, UK

Disgraced surgeon Paolo Macchiarini, who faked research relating to dangerous and largely discredited tracheal transplants, has been handed a 16 month prison sentence in Italy for forging documents and abuse of office.

Macchiarini made headlines around the world after claiming a major breakthrough for patients with failing windpipes, by “seeding” an artificial scaffold with a patient’s own stem cells, to generate a functioning trachea.

But excitement at the prospect of a genuine medical advance turned to scandal when it emerged that Macchiarini had falsified results and misled hospital authorities regarding the health of those receiving the experimental procedures. The revelation prompted his research centre, the Karolinska Institute, to eventually disown his work and saw the Lancet retract two of his research papers.1

Now, after a protracted legal process, beginning in 2012, Macchiarini has been sentenced to 16 months prison by an appeals court in Florence for providing free treatment—a bronchoscopy—at the Careggi University Hospital for a friend who was not in possession of a European health card and therefore not entitled to free treatment. Macchiarini was also found guilty of hiding the patient’s discharge records to conceal his involvement.

His lawyer Francesco Bevacqua said Macchiarini would appeal against the sentence. Two other surgeons, Alessandro Gonfiotti and Fabio Mannini, were sentenced to a year in prison for forgery.

The judge, however, confirmed Macchiarini’s acquittal at a lower court on the charge of manipulating waiting lists. He was previously cleared of unfairly pressuring psychologically vulnerable patients to opt for high cost private procedures.

Last year the Karolinska Institute in Stockholm declared seven researchers responsible for scientific misconduct in a case involving six research articles co-authored by Macchiarini.2

It said that the surgeon—who transplanted synthetic windpipes into three patients at the institute’s sister organisation, Karolinska University Hospital, from 2011 to 2012—was ultimately responsible for the papers. Investigators declared that the articles included “fabricated and distorted descriptions of the patients’ conditions,” and made unjustified claims that the tracheal procedure had been given as a last resort.

The experimental surgery failed. Two of the three transplant recipients, who were said to have undergone the procedure as a last ditch attempt to save their lives, died within a few months.

The Karolinska University Hospital barred further operations with synthetic trachea and decided not to extend Paolo Macchiarini’s contract as surgeon.

Despite this, Macchiarini continued to perform the surgery in Russia.

In 2016, following claims in the magazine Vanity Fair, the Karolinska Institute censured Macchiarini for lying in his CV, which contained “several falsehoods.”3 In March 2017, the last of the three patients to have been given an artificial trachea by Macchiarini at Karolinska University Hospital died at a hospital in the US.

“It’s terrible what this patient had to endure,” said Karin Dahlman-Wright, then acting vice chancellor of the Karolinska Institute. “I deeply regret the suffering caused to her and her family and we dearly wish it had been otherwise.”4

Perhaps most damning, external investigator Kjell Asplund, who was fiercely critical of the Karolinska University Hospital as well the Karolinska Institute, said the suspect operations constituted research and not healthcare.5

One biomedical researcher has documented a total of 20 Macchiarini tracheal regeneration procedures—in Russia, Spain, the UK, and the US, and as well as Sweden. Only three of the 20 recipients are still alive.6


View Abstract

Log in

Log in through your institution


* For online subscription