Elsevier says it will begin investigating two papers coauthored by disgraced surgeon Paolo Macchiarini “soon,” more than a year after two critics of his work formally requested the publisher retract the articles — and nearly a decade after two institutions found him guilty of misconduct for related work.
The papers, published in Biomaterials in 2009 and 2010, include descriptions of a 2008 trachea transplant in Barcelona conducted by Macchiarini — described in The Lancet that year, as well as in a five-year follow-up published in 2013. Both Lancet papers reported a successful surgery and that the patient had a “normal social and working life.” In reality, she needed stents, her lung function did not improve and she eventually had a lung removed.
The Barcelona patient survived, but at least three others who underwent Macchiarini’s synthetic trachea transplants eventually died. In 2023, a Swedish court sentenced Macchiarini to 2.5 years in prison for gross assault related to his failed transplants. So far he has accumulated 13 retractions.
Macchiarini told Retraction Watch our questions were the first he had heard of an effort to retract the two Biomaterials papers, and that neither the journal nor Elsevier had contacted him about them, when we reached him through his Substack account.
“The 2008 Lancet paper has been retracted, and the reasons given for that decision are publicly available,” Macchiarini said, noting that he is neither first nor last author of the two Biomaterials papers in question. “That fact does not, by itself, permit me to determine whether every allegation now being advanced concerning two separate Biomaterials publications is scientifically or factually established.”
In 2017, an ethical review board in Sweden had called for six retractions after finding Macchiarini and several coauthors had committed misconduct. A year later, the Karolinska Institutet, where Macchiarini was employed until his dismissal in 2016, issued similar findings and also called for the retraction of the six papers. These included two other Biomaterials papers. The KI said the authors had “fabricated and distorted” descriptions of the patients and their surgical outcomes.
The Lancet retracted the two papers reporting the Barcelona transplant in 2023, five years after the Swedish ethical review board and Karolinska found Macchiarini committed misconduct.. Those retractions came after another Swedish authority — the National Board for Assessment of Research Misconduct — found Macchiarini guilty of misconduct in his falsified descriptions of the 2008 surgery.
The two Biomaterials papers claimed that a year after the 2008 operation, the graft and the patient were healthy, and that the graft was functioning well. They stated the patient was “fully active and well,” and leading a “near normal life.”
Peter Wilmshurst, a retired cardiologist from the United Kingdom known for exposing flawed medical research, and Patricia Murray, a stem cell biologist at the University of Liverpool, have been pursuing retractions of Macchiarini’s work for years. They requested the retraction of both articles in a letter to Kam Leong, editor-in-chief of Biomaterials, in July last year.
The two papers were part of an effort to “support the original lies,” Murray and Wilmshurst wrote in their letter. The authors “attempt to give undeserved scientific credence to the original false 2008 Lancet paper by suggesting that the authors had spent a long period in incremental scientific developments,” they wrote.
The 2009 article described a “step-wise work plan” that included animal testing before the first human operation. “They didn’t do any animal work before they put these in people,” Wilmshurst told Retraction Watch. “And they claimed that this was years of research, and we know it was actually cooked up in a couple of weeks.”
In their July 2025 letter to Leong, Wilmshurst and Murray also pointed out inconsistent data across the papers. Two histology images in the 2009 article were described as biopsies taken after the transplant. But in the 2010 paper, the same images are said to depict biopsies taken before the procedure. Thirteen of the 14 authors on the 2009 article were also authors of the original paper in The Lancet describing the transplant, including Philipp Jungebluth, also found guilty of scientific misconduct by Karolinska Institute in 2018. In a recent blog post, Wilmshurst and Murray also call out other authors for their role in harming patients.
Loredana De Bartolo, a research director at a membrane technology institute in Italy and coauthor of the 2010 Biomaterials paper Wilmshurst flagged, said she had not heard from either Elsevier or the journal about the article. She said the work identified limitations rather than supporting the transplants, and that the calculations were based on the scientific literature rather than Macchiarini’s studies.
Regarding the inconsistent histology images, she said Macchiarini provided the data, which were incorporated “in good faith” and “could be omitted without in any way compromising the scientific basis, validity, or conclusions of the study.”
“For these reasons, I do not believe that the content of the article provides any grounds for retraction,” she told us. Sara Mantero, of the Polytechnic University of Milan, and corresponding author of the other Biomaterials paper, has not responded to requests for comment.
In July last year, after emailing Leong, who never responded to the letter, Wilmshurst corresponded with staff at Elsevier who told him his concerns had been forwarded to the editor-in-chief and publisher for review, according to emails we have seen. “In early 2018 the editors of the Lancet were aware that the Macchiarini et al paper was false, but it took more than 5 years for the Lancet to retract it,” Wilmshurst wrote in response. “We are concerned that this is a measure of the speed at which Elsevier journals deal with research fraud.”
After a follow up in September 2025, operations staff at the publisher told Wilmshurst his concerns were being investigated, and to expect updates.
Two days later, Wilmshurst followed up again: “If Biomaterials is unwilling to act quickly, we will have little alternative to posting on-line our letter to Biomaterials.”
The next day, Emma Xu, publisher of Biomaterials, told Wilmshurst Macchiarini’s was a “serious case” being handled by a central ethics team. She said Biomaterials had already retracted several of Macchiarini’s articles. “Obviously there are more articles published by Macchiarini” in the journal, “and we need to do individual investigation before actions,” she said.
“Hopefully we could have the solutions soon,” Xu added. Wilmshurst last followed up at the end of July and said he has yet to receive a reply. “They initially said they’re looking into it,” Wilmshurst told us. “They’ve just stopped responding.” Xu and Leong did not respond to our request for comment.
Elsevier told Retraction Watch it had retracted nine papers by Macchiarini in recent years. Rebecca Clear, a spokesperson for the company, said it would “soon investigate the two articles” Wilmshurst flagged, despite telling him last September it already was looking into these papers.
“If deemed appropriate by the journal editors they will be corrected,” Clear said. She could not confirm whether Elsevier had begun investigating the articles at all, nor whether it would only pursue corrections, not retractions.
“Someone may look at it and think, in a few years’ time, that this [transplant] actually worked,” Wilmshurst said. “They may just look at this one paper and think, oh gosh, this works, we’ll try this, and not look at the 2008 Lancet paper and see it’s retracted.”
“Everything that’s false needs to be retracted, doesn’t it?”
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I read from Macchiarini’s substack he is trying to ride Arday’s story and get some sympathy, I guess. It still baffles me that this bloke only did 2.5 years in prison.