Paolo Macchiarini

In footage from SVT Swedish television, Paolo Macchiarini (standing) and colleagues are trying to find clinical records corresponding to a biopsy mentioned in a The Lancet paper.

SVT

Karolinska Institute takes steps to dismiss scandal-plagued surgeon soon

Pressure on surgeon Paolo Macchiarini is increasing as the Karolinska Institute (KI) in Stockholm says it will try to cut ties with him before his current contract runs out in November. Macchiarini, a surgeon who implanted artificial tracheas into patients at KI and elsewhere, is under a cloud of controversy after colleagues and media reports questioned the ethics of the operations and the accuracy of papers he published about their success.

In another development, the medical journal The Lancet yesterday published a letter detailing some of the problems with a key paper Macchiarini published there. The 2011 paper describes early success with the first patient who received the polymer trachea seeded with stem cells; the letter, by two members of the Royal Swedish Academy of Sciences, states that “available information shows that the paper does not present the condition of the patient in a correct way.”

Until now, The Lancet has declined to amend or consider retracting the paper. The journal emphatically defended Macchiarini in an editorial published last year, and on 20 February, Editor-in-Chief Richard Horton wrote in a commentary that the journal would wait for the conclusion of new investigations into the work before deciding what to do. One of the co-authors of the disputed paper, Karl-Henrik Grinnemo, a thoracic surgeon at KI and one of the people who asked the university to investigate Macchiarini, has asked The Lancet several times to remove his name from the publication, but he says the journal has not responded.

On Monday, Karolinska said it had notified Macchiarini that it is considering dismissing him. “His union has also been informed, and Macchiarini and his union now have one week to demand negotiations with KI,” Karolinska spokesperson Claes Keisu wrote to ScienceInsider in an email. The final decision, by the KI Committee for Staff Direct Responsibility, is not expected for several weeks, Keisu wrote. KI had previously said that it had lost confidence in Macchiarini and would sever ties with him when his contract ends in November, but that it would allow him to use the remaining months to wind down his research activities.

KI looked into misconduct allegations against Macchiarini last year. An independent investigator concluded that the discrepancies between clinical records and Macchiarini’s papers constituted misconduct. However, after the report was published, the surgeon and others submitted more than 1000 pages of documents responding to the investigator’s conclusions. In part based on those documents, the vice-chancellor of KI, Anders Hamsten, decided in August 2015 to clear Macchiarini of the charges. In October 2015, the surgeon’s 5-year appointment as a visiting professor ended. The university then gave him a new 1-year contract as a senior researcher.

In January, a documentary broadcast on Swedish television reexamined the story, raising new questions about the work and KI’s investigation. (The program is available online only in Swedish, but the producers have made excerpts available in English here.) An article in Vanity Fair also raised questions about Macchiarini’s CV and cast further doubt on his trustworthiness.

Those reports set off a widening scandal, in which several leading figures at KI have stepped down. Hamsten resigned on 13 February, and on Monday the university’s dean of research, Hans-Gustaf Ljunggren, who advised Hamsten during the misconduct investigation and was involved in the final decision, said he wished to step down as well. Interim Vice-Chancellor Karin Dahlman-Wright said that she understood Ljunggren’s wishes but that “Karolinska Institutet's academic management capacity has been substantially reduced due to recent events, and for that reason, I need to consider when and how I can fulfill his request."

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