Swedish investigation spoils Macchiarini cover-up at Lancet

New developments in the affair of the murderous trachea transplant surgeon and former Karolinska Institutet professor Paolo Macchiarini. The Swedish National Board for Assessment of Research Misconduct (NPOF) made a decision about a 2014 Lancet paper describing Macchiarini’s very first trachea transplant from 2008, which The Lancet keeps defending as scientifically and ethically valid. Well, NPOF confirmed what everyone already knew: the trachea transplant failed, Macchiarini and his gang lied about it, the Lancet study is fraudulent.

Specifically, the NPOF investigation concerned the 5 year follow-up study, it could not investigate the original 2008 report for formal reasons, since Macchiarini and his acolytes Philipp Jungebluth and Silvia Baiguera were not affiliated with Karolinska at that time yet. But fact is: if one of the two papers is proven fraudulent, the other one can’t remain standing. These are the two papers:

• Paolo Macchiarini , Philipp Jungebluth , Tetsuhiko Go , M Adelaide Asnaghi , Louisa E Rees , Tristan A Cogan , Amanda Dodson , Jaume Martorell , Silvia Bellini , Pier Paolo Parnigotto , Sally C Dickinson , Anthony P Hollander , Sara Mantero , Maria Teresa Conconi , Martin A Birchall Clinical transplantation of a tissue-engineered airway The Lancet (2008) doi: 10.1016/s0140-6736(08)61598-6
• Alessandro Gonfiotti , Massimo O Jaus , Daniel Barale , Silvia Baiguera , Camilla Comin , Federico Lavorini , Giovanni Fontana , Oriol Sibila , Giovanni Rombolà , Philipp Jungebluth , Paolo Macchiarini The first tissue-engineered airway transplantation: 5-year follow-up results The Lancet (2014) doi: 10.1016/s0140-6736(13)62033-4

Deadly business

Thanks to Patricia Murray and Elisabeth Woeckner, I could prove already in 2016 that these both studies were fraudulent, and the victim Claudia Castillo has survived not because but despite Macchiarini’s trachea transplant experiment which actually almost killed her:

But big money was involved: Macchiarini’s former British partners at UCL (a university closely connected to The Lancet) has big plans to continue killing people, pardon, earning money with this same technology. There, cadaveric airways from dead donors get stripped of cells (decellurised), seeded with bone marrow cells and implanted into misinformed patients who suffer from various airway defects. The method was proven deadly by both Macchiarini and his UCL colleague Martin Birchall, but because Macchiarini’s later studies with plastic tracheas proved even deadlier (and were retracted), this decell-recell technology with cadaveric airway grafts remains the only available route to money. Another British co-author, Anthony Hollander, is not only Pro-Vice-Chancellor in Liverpool (i.e., Patricia Murray’s boss), he also owns a company marketing bone-marrow technology used in his 2008 transplant with Macchiarini and Birchall. If the two Lancet papers about Claudia’s trachea transplant were to be retracted, these business schemes would crumble completely.

Also, the Lancet Editor-in-Chief Richard Horton doesn’t seem to believe in the existence of medical research fraud and opposes retractions in general. Still, The Lancet did retract some Macchiarini papers, but only upon public demands by the Karolinska Institutet. Read here:

After all, Horton declared in a disastrous 2015 Lancet editorial:

“Paolo Macchiarini is not guilty of scientific misconduct”

“widely disseminated, damaging, and mistaken findings”, “Dragging the professional reputation of a scientist through the gutter of bad publicity” “The allegations made against Paolo Macchiarini were not only harmful to one individual. They also raised questions about the quality of research into regenerative medicine itself.”

This editorial will never be retracted, because Macchiarini is seen by Lancet‘s editors a fellow clinician, a great scientist and a victim of persecution, and it is his critics who are losers, failed scientists and lying fraudsters.

Here they are, the British whistleblowers Patricia Murray and Peter Wilmshurst, about whom Horton even complained to the Committee on Publication Ethics (COPE). Wilmshurst was kicked out as COPE member, yet Horton was advised that he should consider retracting the fraudulent Macchiarini paper, but definitely resist being “stampeded” into such decision by characters like Wilmshurst, Murray and yours truly:

And Horton is resisting. Now it was again Murray and Wilmshurst who succeeded to get the 2014 Macchiarini paper to be declared officially fraudulent, putting The Lancet in zugzwang again. We will get to the NPOF report in a moment.

Thing is, Horton considered the case closed. On 8 February 2023, he issued an Expression of Concern, for both the 2008 and the 2014 Macchiarini papers about Claudia’s trachea transplant. Wilmshurst responded with a long blogpost, reminding what else Horton used to protect from retraction:

“The only morally acceptable course is to retract both fraudulent papers. It appears that Horton has learnt no lessons from refusing to retract the fraudulent publication by Andrew Wakefield that was published in the Lancet exactly 25 years ago on 28^th February 1998.”

The Expression of Concern said specifically this:

“The Lancet has received continuing questions over the reliability of the findings and conduct of this reported case,¹ since Paolo Macchiarini was found guilty of scientific misconduct in 2018.² After an investigation by the head of the institution in Barcelona, Spain, where the patient was originally treated, we were told in 2018 that “upon reviewing all information and after verification of the original documents and records supporting the study, we concluded that there is not enough ground to ask The Lancet for retraction of the article”. We did, however, publish an update of this case from the institution in Barcelona in a letter in 2019 to alert our readers to the subsequent clinical course of the patient.³ The Committee on Publication Ethics (COPE) has discussed these concerns at length again and their view, as an expert body in publication ethics, is that these two unretracted articles^1, 4 should, at a minimum, have received an Expression of Concern given the severity of the concerns raised and the length of time during which the concerns have persisted. As members of COPE, we are now following this advice and are issuing an Expression of Concern for these two Articles.^1, 4, 5“

What happened was this: Antoni Castells, head of the Hospital Clinic Barcelona (where the 2008 trachea transplant was performed), admitted to Murray and to The Lancet that the Macchiarini et al 2008 paper was full of lies, yet he begged Horton not to retract that paper. Remember his name.

Macchiarini was kicked out in Barcelona not just because he faked the results in The Lancet, but because he continued with trachea transplants despite being specifically forbidden to do so. After experimenting on Claudia, Macchiarini killed at least one woman with a trachea transplant, and he definitely tried to kill another. A Spanish victim whom Macchiarini tried to bully into a trachea transplant and threatened with death by denial of healthcare, resisted him and she is still alive. Read her story here:

Guilty of lying

Meanwhile, the Swedish NPOF, the only academic institution worldwide to have ever properly addressed Macchiarini’s fraud, was investigating the 2014 paper about the 5-year follow up. In July 2022, Murray and Wilmshurst took advantage of the fact that Macchiarini, Jungebluth and Baiguera wore at the time of publishing a Swedish institutional affiliation at Karolinska, and reported their 2014 Lancet publication to NPOF. These three authors were subject to NPOF investigations, their coauthors by virtue of abroad affiliation, were not. NPOF obviously could not investigate the 2008 Lancet paper, because at that time no author was affiliated with a Swedish institution. Here is the result, announced by NPOF on 20 September 2023 (translated):

“The Board for Assessment of Research Misconduct (hereinafter the board) decides that Silvia Baiguera, Philipp Jungebluth and Paolo Macchiarini guilty of research misconduct.”

Here is the full NPOF decision:

The document contains this (Google-translated, highlight mine):

“The report states that a stent was placed in the patient’s trachea three weeks later the transplant, because the trachea collapsed. The article describes that a stent was only needed after 6 months. The claim in the report is supported by a letter ² from Dr. Laureano Molins at the hospital in Barcelona where the patient was followed for nine months after the operation by, among others, Dr. Molins and colleagues. The letter was published in the Lancet in 2019 which is six years after the article in question was published online in the Lancet. The current director of the clinic in Barcelona. Dr. Antoni Castells, with whom one of the notifiers had email correspondence since 2018, confirmed that a stent was placed in trachea three weeks after surgery. When Dr. Castells was contacted about this case in June-July 2023, he however stated that he had checked the patient’s medical record again and now could not find information about a stent being placed so soon after the operation. According to him, what is documented in the patient record is that a Bronchoscopy was performed three weeks after the operation and that a stent was inserted only on the 10th October 2008, which is less than four months after the transplant.”

From what I heard, Molins is one of the few decent doctors in this whole farce. He helped the abused Macchiarini victims and his word can be trusted. Now, I don’t know why Castells changed his story. Maybe his Barcelona neighbour Macchiarini paid Castells a visit. Fact is: this clinic director has been working to protect his hospital’s reputation by covering up Macchiarini’s crimes for years. He is determined to prevent the retraction. Horton’s and Castells’ Hypocritic oath is not much better than that of Macchiarini.

In any case, Castells’ new story didn’t convince anyone. From the NPOF report:

“The expert gives examples of several different sections in the summary, results and discussion sections which he assesses to be scientifically incorrect and to constitute forgery, even if a stent was placed at the later time, i.e. shortly before four months. For example, it applies to claims that no complications arose after four months, but also to what one can expect when testing the patient’s lung function at different times.

The expert has examined the suspicious figures and compared them with figures as published or presented on other occasions. His conclusion is that Figure 4 is Figure 3E from Badylak et al. 20l2, rotated and mirrored, and that Figure 5 is the same as Figure 3L in Badylak et al. 2012. Figure 6C is, according to him, duplicated from Baiguera et al. 2010, Figure 11. The figures in the previous publications are according to the expert from examinations performed on patients other than the patient whose follow-up is presented in the current article. The expert’s conclusion is therefore that the figures do not show what they allegedly showed in the article and that they therefore constitute forgeries.”

“Against this background, the board assesses that Paolo Macchiarini knew that a stent was already placed within four months of the operation and that he therefore knew that the article contained incorrect descriptions. Paolo Macchiarini is also a correspondent author of the two articles where the originals of figures 4, 5 and 6C can be found and should thus having known their origin. The board assesses that he intentionally has duplicated the figures and described the follow-up of the patient’s condition at various times incorrectly. […]

The board considers that Silvia Baiguera and Philipp Jungebluth have acted, if not intentionally, then at least grossly negligent, when they have not noticed that the article contains incorrect information, that important information has been omitted and that several figures do not show it purported to show.[…]

In summary, the committee finds that Silvia Baiguera, Philipp Jungebluth and Paolo Macchiarini was guilty of misconduct in research.”

Acted with intent

So the 2014 Lancet paper is now officially fraudulent. On 5 October 2023, NPOF also made a decision on yet another fraudulent Macchiarini paper, on the notice from the four original Karolinska whistleblowers Matthias Corbascio, Thomas Fux, Karl-Henrik Grinnemo and Oscar Sirnonson.

Ylva Gustafsson , Johannes Haag , Philipp Jungebluth , Vanessa Lundin , Mei Ling Lim , Silvia Baiguera , Fatemeh Ajalloueian, Costantino Del Gaudio , Alessandra Bianco , Guido Moll , Sebastian Sjöqvist , Greg Lemon , Ana Isabel Teixeira , Paolo Macchiarini Viability and proliferation of rat MSCs on adhesion protein-modified PET and PU scaffolds Biomaterials (2012) doi: 10.1016/j.biomaterials.2012.07.060 

The verdict (translated):

“The National Board for Assessment of Research Misconduct (hereinafter referred to as the Board) decides that Philipp Jungebluth, Vanessa Lundin, Paolo Macchiarini and Guido Moll are guilty of research misconduct.
The Board decides that Fateineh Ajalloueian, Johannes Haag, Greg Lernon, Mei Ling Lim, Sebastian Sjöqvist and Ana Isabel Teixeira are not guilty of research misconduct.”

Here is the full decision letter:

That Biomaterials paper was based on the eventually retracted 2011 clinical study in The Lancet where Macchiarini and his colleagues at Karolinska and UCL tortured and killed a patient with a plastic trachea tranplant:

NPOF now decided (DeepL-translated):

“Macchiarini is thus considered to have acted with intent and is therefore guilty of misconduct in research.
In addition to Paolo Macchiarini, there are three authors who are covered by the Board’s review and are also the authors of a now withdrawn article describing the operation in question: Philipp Jungebluth, Vanessa Lundin and Guido Moll. This means that they had many opportunities to ask questions about the patient’s condition and had the competence to assess whether the operation could be considered successful. The Board considers that each of them has acted, even if not intentionally, at least grossly negligent when they approved the formulations regarding the previous operation. Philipp Jungebluth, Vanessa Lundin and Guido Moll are thus guilty of research misconduct.”

Jail sentence

Horton’s valued medical peer Macchiarini is not only guilty of research misconduct in several Swedish investigations, but also of a triple aggravated assault with lethal outcome.

In June 2023, Macchiarini was sentenced in a Swedish court for aggravated assault which resulted in deaths of three trachea transplant patients at Karolinska to actual prison time. It’s already his second sentencing, in an appeal hearing. The entire court verdict is below, in Swedish. Here the summary, DeepL-translated:

“The Court of Appeal has concluded that in all three cases Paolo Macchiarini has removed patients’ tracheas and replaced them with synthetic tracheas in the manner stated in the indictment. The Court of Appeal has also concluded that it is proven that the patients have been caused bodily injury and suffering. Like the District Court, the Court of Appeal has found that interventions have not been in accordance with science and proven experience and that the interventions have not been free from punishment with regard to the principle of social adequacy or on the due to consent.

Unlike the District Court, the Court of Appeal has concluded that it was not a matter of emergency situations when the interventions on Andemarian Beyene and Chris Lyles were made. Instead, the investigation indicates that both Andemarian Beyene and Chris Lyles could have been able to live for a significant amount of time without the procedures. With regard to the intervention on Yesim Cetir, the Court of Appeal has concluded that an emergency situation existed but that the intervention was nevertheless unjustifiable. The Court of Appeal has considered that the scope for under the general provision on emergency perform interventions on people in violation of the the regulations that exist for medical care and research must be very limited.
Court of Appeal’s assessment is that even the interventions on Andemarian Beyene and Chris Lyles would have been indefensible if emergency situations had existed.

The Court of Appeal has concluded that Paolo Macchiarini realized the risk that the procedures would cause bodily harm and suffering to the patients and that, even if he had a a hope that the method would work, he was indifferent to the risks. The Court of Appeal has thus held that Mr Macchiarini acted with an intent of indifference.

The offenses have been assessed as three cases of aggravated assault and the sentence has been set at to imprisonment for two years and six months.”

I haven’t heard of Macchiarini actually going to jail in Sweden yet. He probably fled abroad. Maybe to Turkey where he has friends, maybe even back to russia. Or maybe he is enjoying life in his villa in Barcelona because he knows that Spanish police will always be on his side.

Declaration of Helsinki

Another thing which should give Lancet a pause to think over their refusal to retract Macchiarini’s fraud is this highly unexpected retraction. Not about trachea transplant victims, but other dead Karolinska patients whom Macchiarini and his gang tortured and abused:

Philipp Jungebluth, Bernhard Holzgraefe, Mei Ling Lim, Adil Doganay Duru, Vanessa Lundin, Nina Heldring, Oscar P.B. Wiklander, Joel Z. Nordin, Michael Chrobok, Christoph Roderburg, Se­bastian Sjöqvist, Björn Anderstam, Antonio Beltrán Rodríguez, Johannes C. Haag, Ylva Gustafsson, Katharina G. Roddewig, Petra Jones, Matthew J.A. Wood, Tom Luedde, Ana I. Teixeira, Ola Hermanson, Ola Winqvist, Håkan Kalzén, Samir El Andaloussi, Evren Alici, and Paolo Macchiarini “Autologous Peripheral Blood Mononuclear Cells as Treatment in Refractory Acute Respiratory Distress Syndrome” Respiration (2015) DOI: 10.1159/000441799

This was the retraction notice, published on 10 May 2023:

“In 2018, the Vice Chancellor of Karolinska Institutet informed the journal that an institutional investigation found that the research in the article constituted scientific misconduct. The journal was asked to withdraw the article on this basis.

At the time it was concluded by the journal that “We believe that, based on the evidence available to the journal, we are not in the position to make a judgement on the whether or not to retract this article” [1]. The letter from Karolinska Institutet regarding the investigation into the article and the response to the letter by three of the authors of the original article was published [1].

Karolinska Institutet found that the article is “based on data produced through scientific misconduct during the clinical research process. Even though the published paper as such obtained an ethical permit, the underlying research did not” [1]. Karolinska Institutet found that the research “lacked any biological hypothesis based on either in vitro or in vivo (animal) data. The notebook also lacks notes on any advance discussion of the risks and benefits of the treatment, the theory on which it was based, the results of preclinical or other studies demonstrating effect, and safety; nor of any discussion that followed from the deterioration of the patient’s condition, in spite of which it was decided to continue the experimental treatment. This contravenes articles 14, 16, 17, and 21 of the 2013 Declaration of Helsinki (articles 31, 21, 18, and 12 of the 2008 version).” [1]

Upon re-evaluation of the case and in line with the Committee on Publication Ethics Guidelines for Retractions recommending that “Editors should consider retracting a publication if […] it reports unethical research” [2], we are retracting this article.

Ana I. Teixeira, Adil Duru and Vanessa Lundin agree with this retraction. The remaining authors did not respond or could not be reached for comment within the timeframe given.”

Thing is, the journal Respiration and its publisher Karger previously refused to retract this paper and almost literally told the rector of Karolinska to bugger off with his retraction requests. Read here:

Incidentally, the German chief editor of Respiration, the University of Heidelberg professor Felix Herth, is a close collaborator of Jungebluth’s former patron at the same university, Hendrik Dienemann. The latter even re-published the now retracted Respiration case report as a German-language congress abstract (read details here). Jungebluth and all other authors remained, except one small change: Dienemann replaced Macchiarini, thus attributing the Swedish clinical study (and by extension the associated patient abuse) to himself!

Helsinki Convention is obviously something medical journal editor use as toilet paper. But media reporting, also mine, helps to stop this practice. Horton and his Lancet colleagues did not reply to my email. But they know they will eventually have to retract Macchiarini’s last papers in Lancet. It took them 11 years to retract Wakefield’s antivax fraud, with Macchiarini we are now at 7 years. Check again in 2027?

Afterword

As an afterword: I can’t tell you where Macchiarini physically is now. Obviously not in a Swedish jail, maybe getting drunk in his villa in Barcelona. I can tell you that he has active licences to practice medicine in Spain, Italy and in Germany. In fact, Macchiarini remains adjunct professor at the Hannover Medical School (MHH), where he started his adventures in regenerative medicine and tracheal transplants. By order of the MHH rector, any ivestigation of the Macchiarini-supervised doctorate thesis by Philipp Jungebluth has been forbidden. This thesis from 2010 centers on the 2008 trachea transplant, if the Lancet paper were to be retracted, MHH would have to revoke Jungebluth’s medical doctorate degree. Which they are determined never to do.

Jungebluth himself, who was involved with most if not all of Macchiarini’s deadly trachea transplants, abandoned his plans to become thoracic surgeon, then trained for emergency medicine, and now owns a private practice for orthopaedics and sports medicine in his home town of Wolfenbüttel in Lower Saxony, not far from Hannover. He also sings as frontman in a crappy cover band called Doc in the Fog.

Silvia Baiguera and all other Italian coauthors are all in good academic jobs. Why shouldn’t they, Macchiarini and his Italian colleagues Alessandro Gonfiotti and Massimo Jaus left at least 5 trachea tranplant patients dead. And nobody at all, in Florence or elsewhere, cares.

The Lancet only cares about its “reputation”. Meaning, they only retract fraudulent papers when they lose control of media and academic debate. So far, Horton et al managed to keep Macchiarini’s 2008 and 2014 papers completely out of public discussion of the trachea tranplant affair.

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Update 27.10.2023

The Lancet gave up. Both Macchiarini papers are now retracted.

Retraction notice dated 28 October 2023 for Macchiarini et al 2008:

“After The Lancet issued two Expressions of concern in February, 2023^1, 2 for the original case description³ and the 5-year follow-up Article,⁴ the investigation by the Swedish National Board for Assessment of Research Misconduct⁵ into the 5-year follow-up paper has led us to retract this paper.⁶ During that investigation, it was confirmed that a stent was inserted in the patient’s trachea less than 4 months after the operation. The Swedish National Board for Assessment of Research Misconduct⁵ found that the statement made in that Article⁴ that a “4-month follow-up showed no complications” and that omitting information that a stent was inserted constitutes falsification. Similarly, the statement in the original report³ that “the graft immediately provided the recipient with a functional airway, improved her quality of life, and had a normal appearance and mechanical properties at 4 months” would also constitute falsification.⁵ We are, therefore, also retracting the Article of the original case description.
The Editors of The Lancet
The Lancet, London EC2Y 5AS, UK”

Retraction notice, dated 28 October 2023, for Gonfiotti et al 2014:

“Further to the two Expressions of concern The Lancet issued in February, 20231, 2 for the Article presenting the 5-year follow-up results³ of the case of tissue-engineered transplantation,⁴ the Swedish National Board for Assessment of Research Misconduct⁵ has concluded in an investigation into this paper that it “contains fabrication and falsification in several places, and three falsified figures (4, 5 and 6C)”. We are therefore now retracting this Article³ together with the original description of this case.⁶“

I would like to thank again here Patricia Murray, Elizabeth Woeckner and Peter Wilmshurst who helped me fight this murderous fraud. We won. Yes, I know that none of us will be credited.

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