Prison sentence for surgeon who transplanted experimental tracheas

A Swedish court has found a doctor, whose patients died after experimental stem cell-containing tracheas were transplanted, guilty of gross assault and sentenced him to two-and-a-half years in prison.

Surgeon Dr Paolo Macchiarini engineered artificial tracheas (windpipes) by seeding plastic scaffolds with patients' own stem cells, and transplanted them into three Swedish patients in 2011 and 2012 in the Karolinska University Hospital in Stockholm, Sweden. All three died from complications of the transplants.

'Macchiarini was fully aware of the risk that the procedures would cause the patients physical injuries and suffering and that he was indifferent to the realisation of these risks', the Swedish appeals court found. 'The patients have been caused bodily harm and suffering,' and 'could have lived for a not insignificant amount of time without the interventions'.

The court concluded that the first two patients were not emergency cases, so a risky, experimental treatment was not justified. The third case was an emergency, but by that time one of the previous patients had died and the other was experiencing severe complications, meaning Dr Macchiarini was aware of the problems with the technique.

The appeal followed the ruling of a lower court, where Dr Macchiarini was cleared of charges in relation to two of the patients and sentenced to two years' probation in relation to the third.

Dr Macchiarini conducted the same surgery on 17 other patients from Spain, Italy, Russia, Iceland, the UK, and USA. The Russian patient, also not an emergency case, is known to have died, as did the first child patient, who was treated in the USA (see BioNews 703).

Dr Macchiarini was once considered a pioneer in regenerative medicine but his reputation was called into question in 2016 by a documentary that alleged he misled patients about the safety of the transplants, and claimed that animal studies had been successful when none had taken place (see BioNews 839).

He was subsequently fired by the Karolinska Institutet for breaching medical ethics, misrepresenting his work and falsifying his resume, facts that were brought to light in a Vanity Fair article whose source was Dr Macchiarini's former fianceé. He was found guilty of forging documents and abuse of office by an Italian Court in 2019.

Dr Macchiarini does not have to go to prison immediately, as he plans to appeal the verdict. According to Science he denies wrongdoing and queried why he was the only person being held accountable and pointed to other people involved in the operations, and conferences where the transplants had been discussed.