A Swedish filmmaker’s investigative documentary raised further questions, as did a Vanity Fair article detailing how the beguiling surgeon became romantically involved in an NBC producer who was working on a feature about him and apparently led her to to believe he was divorced and would marry her in an official ceremony by the Pope and attended by the Clintons, Obamas, John Legend and Elton John.

The Karolinska Institute fired Dr. Macchiarini, who has long denied scientific misconduct. Magazines withdrew several of his studies. In 2019, an Italian court said he had forged documents and abused his position, charges unrelated to his trachea work. In September he was charged by a Swedish public prosecutor for grievous bodily harm in connection with three trachea transplants. The case is pending.

Dr. Genden said Dr. Macchiarini’s rise and fall have profoundly influenced his own path.

“Here is this handsome Italian surgeon at the best institution in the world, Karolinska, and he’s everything I’m not: He has a beautiful head of hair, he drives a motorcycle, he has an accent, he’s incredibly charismatic and dynamic.” Said Dr. Areas. “He says, ‘I created this bioreactor and its stem cells and it makes trachea.’ And it’s huge. “

Dr. Genden said when he and his colleagues Dr. Macchiarini asked early at a conference: “In his larger-than-life way he says: ‘This is ridiculous, you don’t know what you’re talking about, it works beautifully.'”

Dr. Genden said his work was “out of date, so you basically closed the lab,” he said. “You can’t justify experimental surgery and immunosuppression when you see something else that looks perfect. So you see, wow, we are out of business.”

When Dr. Macchiarini’s work attracted criticism, Dr. Genden got his idea again, but wasn’t sure if he should try. The scandal meant “there is an amazing amount of control,” he said. “We’ll come up and say, ‘As a college student I had this idea on the back of a napkin and now we’re ready to go’ – and if it fails, the patient dies and it becomes another example from a surgeon who thought he was could solve a problem, and instead he created exactly the opposite. “

There was another reason to be discouraged: historical assumptions that the trachea could not be transplanted.