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Paolo Macchiarini was fired by the Karolinska Institute last year.

Lars Granstrand, SVT

Six papers by disgraced surgeon should be retracted, report concludes

Sweden’s national scientific ethics board, the Expert Group on Misconduct in Research, has concluded that six papers authored by disgraced surgeon Paolo Macchiarini should be retracted. The papers describe the purported clinical success of artificial tracheae “seeded” with a patient’s own stem cells. All three patients described in the papers died of complications related to the implant.

The new report reaffirms the conclusions of a 2015 review of the papers, commissioned by Macchiarini’s employer at the time, the Karolinska Institute (KI) in Stockholm. That investigation concluded that Macchiarini and his co-authors were guilty of scientific misconduct, but KI dismissed the report after Macchiarini supplied additional information. It then extended the surgeon’s contract.

A few months later, Macchiarini’s reputation unraveled after a magazine article and a television documentary described falsehoods he had spun in his personal and professional life. Macchiarini was fired, and half a dozen of Macchiarini’s defenders at the university were caught in the fallout. Editorial expressions of concern have been attached to several of the papers, but none have yet been retracted. 

KI then asked the Expert Group, a branch of Sweden’s Central Ethical Review Board, to evaluate the six papers in question. The group asked two external reviewers to look again at the earlier report commissioned by KI and authored by a professor emeritus of surgery at Uppsala University in Sweden, Bengt Gerdin, as well as additional patient data and lab records that had come to light since then. Martin Björck, a professor of surgery at Uppsala University, and Detlev Ganten, chairman of the board of the Charité Foundation in Berlin, concluded that indeed, the papers describe the condition of the patients “as significantly better than was actually the case.” One of the articles also claimed that the surgery had been approved by an ethics committee when it had not. The misleading descriptions and the lack of ethics approval constitute serious enough misconduct that the papers should be retracted, the Expert Group concludes in its 20 October statement.

The group was not asked to address KI’s response to the earlier report, and it does not directly comment on the university’s earlier handling of the matter. It simply says that Gerdin’s review was “painstaking, thorough and analytical.”

All of Macchiarini’s co-authors bear responsibility for the misconduct as well, the group concludes. Although some of the co-authors later became whistleblowers who brought the problems with the papers to light, they are guilty of adding their names to papers that contained false descriptions. The group said it would leave it up to the co-authors’ current employers to decide what punishment is warranted. Ganten said the lesson for co-authors is one of the key conclusions of the report. “If you sign on to a paper, you better know everything about [it],” he says. Some of the co-authors were guilty more of negligence than of real fraud, he says. “Still, a co-author is a co-author.”

KI’s vice-chancellor, Ole Petter Ottersen, will issue an opinion on the report after the co-authors have a chance to respond. The university said in a statement today that it does not know when that process will conclude.