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This programme contains scenes which some viewers may find upsetting | 0:00:02 | 0:00:06 | |
You are really lucky, you know. | 0:00:13 | 0:00:14 | |
Because this morning I fight with | 0:00:14 | 0:00:17 | |
a journalist from Swedish television. | 0:00:17 | 0:00:20 | |
She wanted an interview | 0:00:20 | 0:00:23 | |
about the allegations. | 0:00:23 | 0:00:26 | |
We decided no, not to do it. | 0:00:26 | 0:00:28 | |
This is Paolo Macchiarini, | 0:00:33 | 0:00:35 | |
one of the world's best-known surgeons | 0:00:35 | 0:00:39 | |
in one of his most difficult moments. | 0:00:39 | 0:00:41 | |
He had declined almost every interview from the world's media, | 0:00:43 | 0:00:47 | |
but he agreed to talk just to me. | 0:00:47 | 0:00:49 | |
Perhaps he was hoping it would be an opportunity to tell his version, | 0:00:50 | 0:00:54 | |
or that I at least would tell the story with all its complexities. | 0:00:54 | 0:00:57 | |
Though neither of us knew it then, | 0:01:00 | 0:01:02 | |
this would eventually lead to his spectacular downfall. | 0:01:02 | 0:01:05 | |
At the time, he still enjoyed his reputation | 0:01:07 | 0:01:10 | |
as one of the world's most pioneering surgeons. | 0:01:10 | 0:01:13 | |
Surgeons in Sweden have carried out the world's first transplant | 0:01:20 | 0:01:24 | |
of a synthetic organ... | 0:01:24 | 0:01:25 | |
An 11-year-old boy has had pioneering treatment to | 0:01:25 | 0:01:28 | |
rebuild his windpipe using stem cell... | 0:01:28 | 0:01:31 | |
Macchiarini is trying to solve one of medicine's biggest challenges - | 0:01:31 | 0:01:35 | |
the lack of spare parts when something | 0:01:35 | 0:01:38 | |
goes wrong inside our bodies. | 0:01:38 | 0:01:40 | |
He has already made headlines round the world, | 0:01:41 | 0:01:44 | |
by attempting to create the world's first windpipe out of plastic. | 0:01:44 | 0:01:47 | |
In what seems like the plot from a science fiction novel, | 0:01:49 | 0:01:51 | |
researchers built a new windpipe... | 0:01:51 | 0:01:53 | |
We are just a few years away from all this happening, | 0:01:53 | 0:01:56 | |
all the organs being built in a lab. | 0:01:56 | 0:01:58 | |
So far, there are 17 people around the world who have had one of | 0:01:58 | 0:02:02 | |
Macchiarini's windpipes implanted. | 0:02:02 | 0:02:04 | |
But for most of them, everything still ended the same way - | 0:02:07 | 0:02:11 | |
with death. | 0:02:11 | 0:02:13 | |
You think this is one of the biggest medical scandals? | 0:02:18 | 0:02:20 | |
If you do experimental surgery in humans and you know beforehand | 0:02:21 | 0:02:26 | |
that it's a disaster. | 0:02:26 | 0:02:27 | |
Macchiarini has been accused of falsifying research | 0:02:29 | 0:02:31 | |
and of experimenting on humans. | 0:02:31 | 0:02:35 | |
While I was filming, | 0:02:35 | 0:02:36 | |
police began investigating some of his operations | 0:02:36 | 0:02:39 | |
on suspicion of causing | 0:02:39 | 0:02:41 | |
bodily harm and involuntary manslaughter. | 0:02:41 | 0:02:45 | |
Yet, he still enjoyed the support of the scientific establishment. | 0:02:45 | 0:02:48 | |
So who is Paolo Macchiarini? | 0:03:00 | 0:03:02 | |
Is he a genius? | 0:03:03 | 0:03:04 | |
Or is he a fraud? | 0:03:05 | 0:03:06 | |
How far can you risk a human life in the name of cutting-edge science? | 0:03:09 | 0:03:13 | |
And are some of the world's top medical institutions complicit in | 0:03:14 | 0:03:18 | |
supporting his experimental work? | 0:03:18 | 0:03:20 | |
The process of getting answers was far tougher than I'd anticipated. | 0:03:21 | 0:03:25 | |
Does a human life have a price? | 0:04:32 | 0:04:35 | |
I didn't do anything wrong. | 0:04:38 | 0:04:40 | |
I just did my job. | 0:04:54 | 0:04:56 | |
For me, it all started at the end of 2014, | 0:05:19 | 0:05:22 | |
when Macchiarini was accused of falsifying research results | 0:05:22 | 0:05:26 | |
and of gross misconduct. | 0:05:26 | 0:05:28 | |
Could this really have happened at the Karolinska Institute, | 0:05:29 | 0:05:32 | |
Sweden's prestigious medical university, | 0:05:32 | 0:05:35 | |
the home of the Nobel Prize? | 0:05:35 | 0:05:37 | |
These allegations were very serious, of course. | 0:05:38 | 0:05:40 | |
What if they were true? | 0:05:41 | 0:05:43 | |
I decided to find out what had happened. | 0:05:44 | 0:05:47 | |
And soon I got to meet Paolo Macchiarini | 0:05:50 | 0:05:52 | |
at his lab in the Karolinska Institute in Sweden. | 0:05:52 | 0:05:55 | |
-OK. -OK. -So this... | 0:06:00 | 0:06:04 | |
KEYPAD BEEPS | 0:06:06 | 0:06:08 | |
My first surprise came right away. | 0:06:23 | 0:06:26 | |
Macchiarini's space at the Institute looked so small and modest. | 0:06:26 | 0:06:30 | |
Thank you. | 0:06:30 | 0:06:32 | |
But according to Macchiarini, | 0:06:32 | 0:06:34 | |
big things were happening in this ordinary setting. | 0:06:34 | 0:06:37 | |
This is, however, I think, the most advanced lab | 0:06:37 | 0:06:41 | |
that we do have here. | 0:06:41 | 0:06:44 | |
One of the most advanced in, I can frankly say, in the world. | 0:06:46 | 0:06:51 | |
We have a series of | 0:06:51 | 0:06:55 | |
devices and tools to evaluate | 0:06:55 | 0:06:58 | |
the organs, | 0:06:58 | 0:07:00 | |
whether biological or artificial, | 0:07:00 | 0:07:02 | |
and here we do everything from the brain to the heart, | 0:07:02 | 0:07:06 | |
to the lungs, to the kidney, to the intestines, | 0:07:06 | 0:07:09 | |
to the urethra and other investigations. | 0:07:09 | 0:07:14 | |
Countless people die each year because their organs stop working. | 0:07:18 | 0:07:23 | |
The shortage of new organs is one of medicine's biggest problems | 0:07:23 | 0:07:28 | |
and it is this issue that Macchiarini is trying to solve. | 0:07:28 | 0:07:31 | |
Organs from rats float in these flasks. | 0:07:34 | 0:07:37 | |
Hearts and kidneys, oesophagi and tracheas. | 0:07:38 | 0:07:42 | |
Organs that will bathe in stem cells | 0:07:43 | 0:07:46 | |
and perhaps, one day in the future, become artificial organs. | 0:07:46 | 0:07:50 | |
Macchiarini would revolutionise the medical world, if he succeeds. | 0:07:54 | 0:07:58 | |
Even though the lab is small, this was Macchiarini's main base. | 0:08:00 | 0:08:05 | |
He travels constantly and collaborates with researchers around the world. | 0:08:05 | 0:08:10 | |
'Especially in Russia.' | 0:08:10 | 0:08:12 | |
Findings here, you may apply perhaps in Russia? | 0:08:12 | 0:08:15 | |
Of course, the findings here will be available to everyone because they | 0:08:15 | 0:08:21 | |
will be published in the public domain. | 0:08:21 | 0:08:23 | |
But clearly, by sharing the information, we can move | 0:08:23 | 0:08:29 | |
at a level, at a higher speed and knowledge. | 0:08:29 | 0:08:32 | |
'But it's due to his work in Stockholm | 0:08:34 | 0:08:36 | |
'that he is under pressure now.' | 0:08:36 | 0:08:37 | |
One needs to explain to me what is my interest in... | 0:08:58 | 0:09:01 | |
..doing illegal surgeries or... | 0:09:03 | 0:09:05 | |
..fabricating or manipulating data. | 0:09:07 | 0:09:10 | |
Why I should be so foolish. | 0:09:10 | 0:09:13 | |
Being what the media call me, a superstar, I am always, | 0:09:18 | 0:09:23 | |
in German is "Black Peter", the bad boy. | 0:09:23 | 0:09:26 | |
Being famous, it's very easy to attack... | 0:09:27 | 0:09:29 | |
..before even the judgment has come, the final judgment. | 0:09:31 | 0:09:35 | |
I think it's quite unfair | 0:09:35 | 0:09:38 | |
and has destroyed my reputation and my honourability. | 0:09:38 | 0:09:43 | |
And you know exactly the media don't come back... | 0:09:45 | 0:09:49 | |
..they highlight the bad things, but not the good things. | 0:09:50 | 0:09:54 | |
Hi. | 0:09:59 | 0:10:00 | |
In 2010, Macchiarini was headhunted by the Karolinska Institute to | 0:10:03 | 0:10:08 | |
start up a centre for research and transplantation of new organs. | 0:10:08 | 0:10:12 | |
The whole world of academia competes over famous scientists like | 0:10:15 | 0:10:19 | |
Macchiarini. Almost how sports clubs buy players. | 0:10:19 | 0:10:23 | |
Top scientists can mean both revolutionary discoveries | 0:10:25 | 0:10:28 | |
and bigger grants for the university. | 0:10:28 | 0:10:31 | |
The very best are hunted from all over the world. | 0:10:33 | 0:10:35 | |
And Macchiarini has also been signed up by Russia. | 0:10:38 | 0:10:41 | |
I travelled with Paolo to Krasnodar, | 0:10:55 | 0:10:58 | |
the south of the country, his second base. | 0:10:58 | 0:11:00 | |
This was the start of several long journeys. | 0:11:05 | 0:11:07 | |
Macchiarini's story was much bigger and stranger | 0:11:09 | 0:11:12 | |
than I ever could have imagined. | 0:11:12 | 0:11:15 | |
-Hello. -Hello, how are you? -Fine, how are you? | 0:11:16 | 0:11:18 | |
Good. | 0:11:18 | 0:11:20 | |
Not usually. | 0:11:25 | 0:11:26 | |
I'm working for the university. | 0:11:37 | 0:11:39 | |
We are trying to create new organs. | 0:11:41 | 0:11:43 | |
Frankenstein. | 0:11:46 | 0:11:47 | |
It hit me how untouched Paolo seemed | 0:11:53 | 0:11:55 | |
by the allegations that had been made against him. | 0:11:55 | 0:11:58 | |
It was as if it was just a minor glitch. | 0:11:59 | 0:12:02 | |
Macchiarini had set himself far more ambitious goals. | 0:12:03 | 0:12:06 | |
'My dream would be, as I always say,' | 0:12:08 | 0:12:11 | |
to avoid the surgery. | 0:12:11 | 0:12:14 | |
It's crazy, right? A surgeon who would say that. | 0:12:14 | 0:12:17 | |
But, for instance, use the cells to restore the function of an organ. | 0:12:17 | 0:12:22 | |
That would be perfect. | 0:12:22 | 0:12:23 | |
So cell therapy, is, to my eyes, the future. | 0:12:26 | 0:12:30 | |
Paolo was hoping to change the very foundations of modern medical care. | 0:12:32 | 0:12:37 | |
It's been a long fight for you to do this? | 0:12:39 | 0:12:42 | |
Oh, yes. | 0:12:43 | 0:12:44 | |
Do you feel that you are closer to | 0:12:45 | 0:12:48 | |
actually succeeding now than you have been before? | 0:12:48 | 0:12:50 | |
If I would have more time to dedicate to science, | 0:12:51 | 0:12:54 | |
without dealing with all this... | 0:12:54 | 0:12:58 | |
other issues and complaints, | 0:12:58 | 0:13:00 | |
allegations and attacks and so forth, then, yes. | 0:13:00 | 0:13:03 | |
So the allegations and the complaints, | 0:13:07 | 0:13:10 | |
they do hinder your work, | 0:13:10 | 0:13:11 | |
they take up a lot of time? | 0:13:11 | 0:13:14 | |
Right now, I'm doing almost only that, | 0:13:14 | 0:13:15 | |
so clearly I cannot have a relaxed and creative mind | 0:13:15 | 0:13:21 | |
right now. | 0:13:21 | 0:13:23 | |
It's been going on six months. | 0:13:23 | 0:13:25 | |
Interesting, something you can talk about? | 0:13:27 | 0:13:31 | |
No, because the deal was, we would not talk about this, remember that? | 0:13:31 | 0:13:35 | |
'Of course I remembered. | 0:13:37 | 0:13:38 | |
'Macchiarini had let me into his world on one condition, | 0:13:39 | 0:13:43 | |
'he wanted to bide his time before responding to the allegations. | 0:13:43 | 0:13:47 | |
'His Swedish employer, the Karolinska Institute, | 0:13:48 | 0:13:51 | |
'was still investigating his case. | 0:13:51 | 0:13:53 | |
'The process must be allowed to run its course.' | 0:13:53 | 0:13:57 | |
Perfect. | 0:13:57 | 0:13:58 | |
Like it. | 0:14:10 | 0:14:11 | |
Changes. | 0:14:11 | 0:14:12 | |
OK, see you later or tomorrow morning. | 0:14:15 | 0:14:17 | |
Later, or tomorrow morning? About six. | 0:14:17 | 0:14:19 | |
OK. See you, cheers, Paolo, it was really nice. | 0:14:21 | 0:14:24 | |
Good. | 0:14:24 | 0:14:25 | |
Here, in southern Russia, near Crimea and the Black Sea, | 0:14:49 | 0:14:53 | |
Paolo is creating a centre for transplantation and research. | 0:14:53 | 0:14:58 | |
It aims to be world leading. | 0:14:58 | 0:14:59 | |
The base of the project is Paolo's lab at the University of Krasnodar. | 0:15:04 | 0:15:08 | |
Wait... | 0:15:25 | 0:15:27 | |
-Sorry. -You should come now... | 0:15:28 | 0:15:30 | |
Who? Now. | 0:15:30 | 0:15:32 | |
OK... | 0:15:32 | 0:15:33 | |
Elena Gubareva is Paolo's research director here. | 0:15:33 | 0:15:38 | |
She has created an artificial diaphragm, | 0:15:38 | 0:15:40 | |
one of the muscles we use to breathe. | 0:15:40 | 0:15:43 | |
She has done, | 0:15:43 | 0:15:44 | |
I mean, the leader on this, | 0:15:44 | 0:15:46 | |
transplanting the entire diaphragm on the left side... | 0:15:46 | 0:15:50 | |
-Incredible. -..which is incredible. | 0:15:50 | 0:15:52 | |
Just incredible. Nobody has done that with that success rate. | 0:15:52 | 0:15:56 | |
But...nobody believes it. | 0:15:56 | 0:16:00 | |
Whether it is because it is coming from Russia, | 0:16:00 | 0:16:05 | |
whether it is because I am under investigation | 0:16:05 | 0:16:09 | |
from all these allegations, | 0:16:09 | 0:16:11 | |
whether it is because it is too incredible. | 0:16:11 | 0:16:14 | |
So we are having difficulties in... | 0:16:14 | 0:16:18 | |
publishing it, but you will see it, how it works. | 0:16:18 | 0:16:23 | |
So that's... | 0:16:23 | 0:16:25 | |
..part of the challenge of this new field, this high technology, | 0:16:27 | 0:16:34 | |
this new advanced field. | 0:16:34 | 0:16:37 | |
Everything that is new scares and people do not trust, | 0:16:37 | 0:16:41 | |
it's like Mahatma Gandhi, | 0:16:41 | 0:16:43 | |
first they don't believe, | 0:16:43 | 0:16:45 | |
then they criticise you and then they start to... | 0:16:45 | 0:16:48 | |
When you were dying, when you die, maybe you were right. | 0:16:48 | 0:16:52 | |
Maybe. | 0:16:52 | 0:16:53 | |
But I'm not Mahatma Gandhi. | 0:16:54 | 0:16:55 | |
OK, I think you should wear your coat | 0:16:58 | 0:17:01 | |
because we should go... | 0:17:01 | 0:17:04 | |
OK. | 0:17:04 | 0:17:05 | |
'Elena shows me the rest of the lab. | 0:17:05 | 0:17:08 | |
'This is a controversial part of medical research. | 0:17:08 | 0:17:11 | |
'Most people are never allowed in.' | 0:17:11 | 0:17:13 | |
You should go to animal. | 0:17:13 | 0:17:15 | |
This is cages for animals, this is for big animals, | 0:17:22 | 0:17:25 | |
for pigs, which will bring us in future. | 0:17:25 | 0:17:29 | |
These cages are for rabbits and rats. | 0:17:29 | 0:17:33 | |
They live here. This is for different types of investigation. | 0:17:33 | 0:17:37 | |
Right, are you ready? | 0:17:44 | 0:17:46 | |
-Just a minute, please. -Just a minute, OK. | 0:17:48 | 0:17:51 | |
We will go in the surgical room to do all the steps of the operation. | 0:17:51 | 0:17:56 | |
You can see. And now we will bring it to a surgical room. | 0:18:08 | 0:18:13 | |
Experiments on cells alone are often not enough to prove if a treatment | 0:18:32 | 0:18:37 | |
will work on the human body. | 0:18:37 | 0:18:39 | |
But if the experiments aren't performed on a human guinea pig, | 0:18:40 | 0:18:44 | |
you may need something else. | 0:18:44 | 0:18:46 | |
It might seem cruel, | 0:18:49 | 0:18:51 | |
and at times it is. | 0:18:51 | 0:18:53 | |
First, you remove the diaphragm from the donor rat. | 0:18:58 | 0:19:03 | |
The muscle is then washed in strong chemicals | 0:19:06 | 0:19:08 | |
so that all the donor cells are gone. | 0:19:08 | 0:19:11 | |
You are then left with a dead scaffold of a diaphragm. | 0:19:13 | 0:19:16 | |
This scaffold is then submerged in a solution of stem cells from the rat | 0:19:20 | 0:19:25 | |
that will receive the new muscle. | 0:19:25 | 0:19:27 | |
Then the rat that will get the new muscle, the receiver rat, | 0:19:30 | 0:19:33 | |
is opened up and the old diaphragm is removed. | 0:19:33 | 0:19:36 | |
The new muscle scaffold is taken out of its bath and implanted into the | 0:19:38 | 0:19:43 | |
receiver rat. | 0:19:43 | 0:19:44 | |
The idea is that the stem cells will morph into different | 0:19:47 | 0:19:50 | |
cell types to create a new organ. | 0:19:50 | 0:19:53 | |
This is animals after treatment and these two rats are rats after | 0:19:57 | 0:20:02 | |
transplantation of diaphragm after six months. | 0:20:02 | 0:20:06 | |
They are absolutely healthy | 0:20:06 | 0:20:08 | |
and there are no problems with health. | 0:20:08 | 0:20:11 | |
They have a good health status. | 0:20:11 | 0:20:14 | |
These two guys are basically world unique, right? | 0:20:14 | 0:20:16 | |
Yep, yep. | 0:20:16 | 0:20:18 | |
-The first? -The first. | 0:20:18 | 0:20:20 | |
'According to Gubareva and Macchiarini, | 0:20:20 | 0:20:22 | |
'these two rats are the first animals in the world | 0:20:22 | 0:20:25 | |
'to breathe with the help of an artificial muscle.' | 0:20:25 | 0:20:28 | |
100 years ago, everybody said that heart transplantation is impossible, | 0:20:28 | 0:20:34 | |
but now we can see that heart transplantation is not routine, | 0:20:34 | 0:20:38 | |
but everybody knows it is possible to do. | 0:20:38 | 0:20:42 | |
It's very important, never stop. | 0:20:42 | 0:20:44 | |
Try to do everything what you can. | 0:20:44 | 0:20:47 | |
-Bye. -Bye-bye. | 0:20:48 | 0:20:49 | |
'I got to see more and more of the lab and I couldn't help but be | 0:20:50 | 0:20:54 | |
'impressed. What they were trying to achieve was simply great. | 0:20:54 | 0:20:59 | |
'To Gubareva and Macchiarini it didn't seem to be questioned IF | 0:20:59 | 0:21:03 | |
'the new method with transplanted organs would ever become reality, | 0:21:03 | 0:21:07 | |
'but rather WHEN the big breakthrough would happen.' | 0:21:07 | 0:21:10 | |
We started with the trachea and now we are at | 0:21:10 | 0:21:13 | |
a higher level of complexity | 0:21:13 | 0:21:15 | |
because the oesophagus needs to contract, | 0:21:15 | 0:21:19 | |
the muscle diaphragm needs to contract, so all this capacities, | 0:21:19 | 0:21:24 | |
function capacities, needs to be preserved. | 0:21:24 | 0:21:26 | |
We do hope that | 0:21:28 | 0:21:31 | |
possibly in the middle of next year we could think to, | 0:21:31 | 0:21:36 | |
after having all the ethical commissions clearance, | 0:21:36 | 0:21:39 | |
to have the green light to do it in humans. | 0:21:39 | 0:21:42 | |
Paolo told me he intends to go from rat to human in just one year, | 0:21:49 | 0:21:54 | |
which is fast. | 0:21:54 | 0:21:56 | |
And during this time, | 0:21:59 | 0:22:00 | |
he will also need to test his new artificial muscles on more animals. | 0:22:00 | 0:22:04 | |
Here in Sochi, near the Black Sea, | 0:22:11 | 0:22:13 | |
there is one of the world's largest facilities | 0:22:13 | 0:22:16 | |
for experiments on monkeys. | 0:22:16 | 0:22:17 | |
Under communism, well guarded secret departments of the Soviet military | 0:22:19 | 0:22:23 | |
were located here. | 0:22:23 | 0:22:24 | |
Civilian scientists are now able to experiment | 0:22:26 | 0:22:28 | |
on the thousands of monkeys that live here. | 0:22:28 | 0:22:31 | |
But the preparations for Paolo's trials here in Sochi | 0:22:34 | 0:22:37 | |
have been delayed. | 0:22:37 | 0:22:38 | |
-Hello. -Hello, nice to meet you. | 0:22:45 | 0:22:47 | |
How are you? | 0:22:47 | 0:22:48 | |
'We are about four months...' | 0:22:55 | 0:22:57 | |
We have a four-month delay | 0:22:59 | 0:23:01 | |
on the timescale because we haven't done that much progress since we | 0:23:01 | 0:23:07 | |
started, and this... | 0:23:07 | 0:23:09 | |
Research grants are so strict that if we don't provide results, | 0:23:11 | 0:23:15 | |
then we will not be able to continue the grant. | 0:23:15 | 0:23:18 | |
She wanted to know which, | 0:23:26 | 0:23:28 | |
-what timing for grant, this research. -Yesterday. | 0:23:28 | 0:23:31 | |
-Yesterday. -My problem is that nothing happens, and I hate that. | 0:23:31 | 0:23:35 | |
I mean, it makes no sense, and then we talk and we talk and we talk, | 0:23:35 | 0:23:40 | |
and nothing happens. | 0:23:40 | 0:23:41 | |
The last time we met in December and now we are | 0:23:41 | 0:23:45 | |
almost in April and nothing has been done, and clearly we cannot | 0:23:45 | 0:23:51 | |
continue in this way because otherwise when we need to do | 0:23:51 | 0:23:54 | |
the technical report of the project... | 0:23:54 | 0:23:56 | |
Nyet, nyet, nyet. | 0:23:56 | 0:24:00 | |
Then it's very bad. | 0:24:00 | 0:24:02 | |
Unfortunately, things need to be done, so... | 0:24:07 | 0:24:10 | |
Ladies! | 0:24:13 | 0:24:14 | |
Normally, scientists would start with test tubes, | 0:24:23 | 0:24:27 | |
then experiment on rats, | 0:24:27 | 0:24:29 | |
move on to bigger animals and after that, humans. | 0:24:29 | 0:24:33 | |
That is usually how medical research works to avoid the risks escalating. | 0:24:35 | 0:24:40 | |
If Paolo had always worked in this way, | 0:24:42 | 0:24:44 | |
this film may never have happened. | 0:24:44 | 0:24:46 | |
But he hasn't. | 0:24:48 | 0:24:49 | |
Though Paolo aimed to test on animals here in Krasnodar, | 0:24:55 | 0:24:59 | |
he'd already tested a similar method on humans. | 0:24:59 | 0:25:02 | |
It was in 2008 that he took that controversial step. | 0:25:04 | 0:25:07 | |
This is Claudia Castillo. | 0:25:11 | 0:25:12 | |
She sought Macchiarini's help | 0:25:14 | 0:25:16 | |
after one of her bronchi had closed up. | 0:25:16 | 0:25:18 | |
A defect which medicine back then couldn't cure. | 0:25:20 | 0:25:22 | |
This was something completely new - tracheas and stem cells. | 0:25:37 | 0:25:41 | |
This is how it was explained to the world... | 0:25:41 | 0:25:43 | |
Paolo cut out a piece of the windpipe from a dead donor. | 0:25:46 | 0:25:49 | |
The piece was then washed clean of donor cells. | 0:25:53 | 0:25:55 | |
Then Claudia's stem cells were taken from her bone marrow. | 0:25:59 | 0:26:02 | |
The cleansed windpipe was bathed in Claudia's stem cell solution and | 0:26:06 | 0:26:11 | |
a little piece of it was inserted into Claudia. | 0:26:11 | 0:26:14 | |
Even if Macchiarini had taken big risks, | 0:26:34 | 0:26:36 | |
it all seemed to have worked out. | 0:26:36 | 0:26:39 | |
'The scientists believe their technique can immediately help up to | 0:26:40 | 0:26:44 | |
'3,000 people like Claudia across Europe | 0:26:44 | 0:26:46 | |
'and eventually tens of thousands | 0:26:46 | 0:26:48 | |
'more with diseases like cancer of the larynx.' | 0:26:48 | 0:26:51 | |
Macchiarini's method became world news. | 0:26:51 | 0:26:54 | |
The prestigious medical journal the Lancet ranked his research article | 0:26:55 | 0:27:00 | |
amongst the year's ten most important. | 0:27:00 | 0:27:02 | |
So, in this case, it's not just a promise, | 0:27:04 | 0:27:07 | |
we've achieved what we set out to do. | 0:27:07 | 0:27:08 | |
It's a major achievement in the history of medicine. | 0:27:08 | 0:27:11 | |
In a short space of time, | 0:27:15 | 0:27:17 | |
Macchiarini went on to transplant several new tracheas. | 0:27:17 | 0:27:20 | |
In London, he participated in an operation | 0:27:25 | 0:27:28 | |
on a ten-year-old Irish boy, | 0:27:28 | 0:27:30 | |
who was born with a trachea too small. | 0:27:30 | 0:27:32 | |
'It saved his life and has been described as a kind of miracle.' | 0:27:32 | 0:27:37 | |
In Moscow, on a woman from Kazakhstan, | 0:27:37 | 0:27:41 | |
and in Florence, on a young British woman with cancer. | 0:27:41 | 0:27:45 | |
Macchiarini's status as a star was now at its peak. | 0:27:50 | 0:27:54 | |
He was desirable prey for universities and hospitals | 0:28:11 | 0:28:14 | |
around the globe, | 0:28:14 | 0:28:17 | |
but in the end, it was Russia and Sweden who hired him. | 0:28:17 | 0:28:21 | |
Macchiarini took the Karolinska Institute by storm, | 0:28:23 | 0:28:26 | |
not least among the surgeons, who thought he was fantastic. | 0:28:26 | 0:28:29 | |
Here was a colleague who was not only extremely competent in his | 0:28:31 | 0:28:34 | |
handiwork, but he also seemed to be revolutionising an entire science. | 0:28:34 | 0:28:39 | |
Karl-Henrik Grinnemo is a surgeon and researcher. | 0:29:09 | 0:29:13 | |
Together with his colleague, Matthias Corbascio, | 0:29:13 | 0:29:16 | |
he was asked to help Macchiarini set up the unit. | 0:29:16 | 0:29:19 | |
Macchiarini was now commissioned to start up an international centre for | 0:29:40 | 0:29:44 | |
transplantation and surgery at the Karolinska Institute. | 0:29:44 | 0:29:47 | |
He was meant to do research at the Institute | 0:29:48 | 0:29:51 | |
and also perform experimental surgery at its hospital. | 0:29:51 | 0:29:54 | |
Paolo had also been asked to do research on other vital organs. | 0:30:17 | 0:30:22 | |
But the pressure was intense. | 0:31:12 | 0:31:14 | |
Paolo was expected to have started | 0:31:16 | 0:31:18 | |
ground-breaking operations within three months. | 0:31:18 | 0:31:21 | |
But months went by without Paolo performing a single transplant. | 0:31:24 | 0:31:28 | |
And he was also facing other problems. | 0:31:31 | 0:31:34 | |
Paolo had carried out transplants | 0:31:36 | 0:31:38 | |
on nearly ten patients using his new method, | 0:31:38 | 0:31:40 | |
but several tracheas had started to collapse. | 0:31:40 | 0:31:44 | |
How was he going to solve this? | 0:31:45 | 0:31:47 | |
Paolo had a new idea. | 0:31:48 | 0:31:50 | |
This time, something really untested. | 0:31:50 | 0:31:53 | |
He would stop the transplants using donated wind pipes, | 0:31:54 | 0:31:58 | |
and instead manufacture artificial ones out of plastic. | 0:31:58 | 0:32:02 | |
But who would be the guinea pig? | 0:32:04 | 0:32:06 | |
By chance, he came across a patient in Iceland. | 0:32:12 | 0:32:15 | |
A student from Eritrea by the name of Andemariam Beyene. | 0:32:16 | 0:32:20 | |
Andemariam was studying geothermal energy. | 0:32:21 | 0:32:24 | |
He was finding it hard to breathe. | 0:32:27 | 0:32:29 | |
For a while he thought it was asthma, but the drugs didn't help. | 0:32:31 | 0:32:35 | |
Then his Icelandic doctor discovered he had cancer of the trachea. | 0:32:35 | 0:32:40 | |
In 2011, Andemariam's ability to breathe worsened again. | 0:32:56 | 0:33:01 | |
His Icelandic doctor began to look abroad for specialist help. | 0:33:01 | 0:33:05 | |
The Karolinska Hospital suggested Macchiarini. | 0:33:05 | 0:33:09 | |
One patient was referred from Iceland that was given, | 0:33:09 | 0:33:14 | |
in Harvard in Boston, | 0:33:14 | 0:33:16 | |
a life expectancy of six months because he was already operated on. | 0:33:16 | 0:33:20 | |
He had a shortness of breath | 0:33:20 | 0:33:22 | |
and the case was discussed here, multidisciplinary and... | 0:33:22 | 0:33:27 | |
..we decided that he was at risk of suffocation. | 0:33:29 | 0:33:31 | |
We were in need of something now and not tomorrow. | 0:33:33 | 0:33:37 | |
Paolo now decided to try his new idea with plastic tracheas on Andemariam. | 0:33:37 | 0:33:41 | |
Compared to the old procedure that we did so far since 2008, | 0:33:43 | 0:33:48 | |
a completely new approach where | 0:33:48 | 0:33:51 | |
we don't use natural wind pipes, | 0:33:51 | 0:33:56 | |
but synthetic polymers to build a custom-made individual windpipe. | 0:33:56 | 0:34:04 | |
The operation was performed | 0:34:07 | 0:34:09 | |
at Karolinska University Hospital in June 2011. | 0:34:09 | 0:34:12 | |
Karl-Henrik Grinnemo was one of several surgeons | 0:34:18 | 0:34:21 | |
who assisted during the operation. | 0:34:21 | 0:34:23 | |
The surgery was very difficult. | 0:35:09 | 0:35:11 | |
You had three experienced surgeons at the operating table, | 0:35:11 | 0:35:15 | |
but believe me, it was one of the most difficult surgeries we did | 0:35:15 | 0:35:19 | |
and it was the first time we used this material. | 0:35:19 | 0:35:22 | |
Not optimum material, because it was done in a hurry and to afford. | 0:35:22 | 0:35:27 | |
A ground-breaking surgery gave a man back his trachea and his life. | 0:36:48 | 0:36:52 | |
He is the first person... | 0:36:52 | 0:36:54 | |
There were great headlines, and just as they had hoped, | 0:36:54 | 0:36:57 | |
Macchiarini and the Karolinska Institute | 0:36:57 | 0:36:59 | |
caught the world's attention. | 0:36:59 | 0:37:00 | |
It's his tissue, it's his cells, | 0:37:00 | 0:37:02 | |
but those cells have differentiated | 0:37:02 | 0:37:04 | |
from bone marrow cells to become all the different cell types. | 0:37:04 | 0:37:07 | |
So it really is a living, breathing organ at this point. | 0:37:07 | 0:37:10 | |
Over a month later, Beyene is not only breathing, | 0:37:10 | 0:37:12 | |
but on the road to recovery. | 0:37:12 | 0:37:15 | |
He is soon to be discharged from the hospital and heading home to his family. | 0:37:15 | 0:37:19 | |
But things didn't look quite as good | 0:37:19 | 0:37:21 | |
for one of Macchiarini's earlier patients, Keziah Shorten... | 0:37:21 | 0:37:25 | |
..the young British woman who Macchiarini had | 0:37:27 | 0:37:30 | |
transplanted a donated trachea into in Florence. | 0:37:30 | 0:37:33 | |
After some time at home in England, | 0:37:35 | 0:37:38 | |
her doctors observed that | 0:37:38 | 0:37:40 | |
the transplant had failed and that her windpipe was hanging loose. | 0:37:40 | 0:37:44 | |
For a long time, her British doctors | 0:37:46 | 0:37:48 | |
had been collaborating with Macchiarini, | 0:37:48 | 0:37:51 | |
but now they had to manage a disastrous situation on their own. | 0:37:51 | 0:37:55 | |
We were faced with a very difficult clinical problem here at UCL, | 0:37:56 | 0:38:02 | |
of a girl, aged 20, who had had a terrible carcinoma, | 0:38:02 | 0:38:06 | |
cancer of her windpipe, | 0:38:06 | 0:38:08 | |
and had had this operated on elsewhere. | 0:38:08 | 0:38:11 | |
She'd had the windpipe essentially removed, | 0:38:12 | 0:38:14 | |
reconstructed in a different way, and that had all broken down. | 0:38:14 | 0:38:18 | |
However, having seen what had happened in Sweden, | 0:38:20 | 0:38:23 | |
we felt this offered her some chance. | 0:38:23 | 0:38:26 | |
The plastic trachea Macchiarini had used on Andemariam had been | 0:38:28 | 0:38:31 | |
manufactured in London by one of Birchall's colleagues. | 0:38:31 | 0:38:35 | |
Birchall now ordered one more for Keziah. | 0:38:37 | 0:38:40 | |
We did put a synthetic. | 0:38:43 | 0:38:45 | |
I was the one who stitched in the top end, and my thoracic colleagues | 0:38:45 | 0:38:48 | |
stitched from the bottom end of this synthetic implant. | 0:38:48 | 0:38:51 | |
Even when working with it, you could tell it was too rigid, it wasn't... | 0:38:51 | 0:38:55 | |
You couldn't see any evidence of any cells there. | 0:38:55 | 0:38:58 | |
Microscopically, there may have been some cells. | 0:38:58 | 0:39:01 | |
There was certainly no respiratory lining. | 0:39:01 | 0:39:03 | |
Um, I... | 0:39:03 | 0:39:05 | |
You know, it was a bit of plastic. | 0:39:05 | 0:39:07 | |
An expensive bit of plastic. | 0:39:07 | 0:39:09 | |
I couldn't see it working, and sure enough, it didn't work. | 0:39:10 | 0:39:13 | |
Keziah's trachea was made from the same plastic as Andemariam's. | 0:39:15 | 0:39:19 | |
It was a special plastic called POSS-PCU. | 0:39:21 | 0:39:24 | |
The POSS-PCU had not performed as well as we'd hoped. | 0:39:26 | 0:39:29 | |
It hadn't integrated into its surroundings very well | 0:39:29 | 0:39:32 | |
and had become infected, | 0:39:32 | 0:39:34 | |
principally with fungus, but also with some bacteria as well. | 0:39:34 | 0:39:36 | |
The two ends of the trachea, really, were very loose, | 0:39:39 | 0:39:42 | |
they had not integrated at all. | 0:39:42 | 0:39:44 | |
There were sutures that were holding it in place, but very loosely. | 0:39:44 | 0:39:47 | |
She remained on the intensive care unit at UCL | 0:39:48 | 0:39:51 | |
for another six weeks or so, | 0:39:51 | 0:39:52 | |
but then was able to be discharged back to Brighton, | 0:39:52 | 0:39:55 | |
on the south coast of England, to be with her family for a few months. | 0:39:55 | 0:39:58 | |
Keziah's condition worsened. | 0:40:02 | 0:40:04 | |
Shortly afterwards, she passed away. | 0:40:05 | 0:40:08 | |
The material doesn't really work, basically. | 0:40:11 | 0:40:13 | |
In its present form, that particular material | 0:40:13 | 0:40:17 | |
is not the solution to tracheal transplantation right now. | 0:40:17 | 0:40:22 | |
But the British surgeons weren't the only ones | 0:40:39 | 0:40:41 | |
doubting Paolo's plastic tracheas. | 0:40:41 | 0:40:43 | |
A colleague of theirs, Pierre Delaere, was working in Belgium. | 0:40:45 | 0:40:49 | |
He was astounded to hear about Paolo's operation on Andemariam. | 0:40:50 | 0:40:54 | |
Delaere warned the Vice Chancellor at Karolinska. | 0:41:42 | 0:41:45 | |
He claimed that Macchiarini's research studies | 0:41:46 | 0:41:49 | |
were misleading the general public and the medical world, | 0:41:49 | 0:41:51 | |
making people believe that plastic tracheas actually worked, | 0:41:51 | 0:41:55 | |
despite it being physically impossible. | 0:41:55 | 0:41:58 | |
Karolinska ignored the warning. | 0:42:37 | 0:42:40 | |
And the hospital went ahead with the next plastic operation | 0:42:41 | 0:42:45 | |
on an American suffering from cancer, | 0:42:45 | 0:42:48 | |
who had found Macchiarini on the internet. | 0:42:48 | 0:42:50 | |
My name is Christopher Lyles. | 0:42:50 | 0:42:52 | |
Born and raised in Maryland, graduated Morgan State University. | 0:42:54 | 0:42:58 | |
I have a four-year-old. | 0:42:58 | 0:43:01 | |
I want to see her grow. | 0:43:01 | 0:43:02 | |
I'm not going anywhere. | 0:43:05 | 0:43:06 | |
Lyles was operated on in November 2011. | 0:43:10 | 0:43:13 | |
Just four months later he was dead. | 0:43:14 | 0:43:17 | |
Two out of the world's three patients | 0:43:19 | 0:43:21 | |
with plastic tracheas were now dead. | 0:43:21 | 0:43:24 | |
But Delaere's warnings never took hold in the media. | 0:43:26 | 0:43:29 | |
From the outside it all looked good. | 0:43:29 | 0:43:32 | |
During the spring of 2012, | 0:43:35 | 0:43:37 | |
a German TV crew began to follow Macchiarini very closely. | 0:43:37 | 0:43:41 | |
The scan would be, eventually, of some help as well. | 0:43:41 | 0:43:45 | |
So... | 0:43:45 | 0:43:47 | |
Here are some shots from the German team's unedited footage. | 0:43:47 | 0:43:50 | |
When I see this, it feels like stepping into a time machine, | 0:43:51 | 0:43:55 | |
as everything was caught on tape, | 0:43:55 | 0:43:58 | |
not least the difficulties with Macchiarini's project. | 0:43:58 | 0:44:01 | |
But, please, try to answer this question, | 0:44:02 | 0:44:05 | |
because he's making me crazy. I hate that. | 0:44:05 | 0:44:07 | |
In this material, I would make several serious discoveries. | 0:44:07 | 0:44:12 | |
May Lin. | 0:44:12 | 0:44:14 | |
You do not forget me. | 0:44:15 | 0:44:16 | |
OK, bye. | 0:44:18 | 0:44:19 | |
Bye. | 0:44:20 | 0:44:21 | |
Wow. | 0:44:22 | 0:44:24 | |
Behind the scenes, Paolo was obviously well aware of the death. | 0:45:04 | 0:45:09 | |
But it didn't seem to stop him. | 0:45:09 | 0:45:11 | |
Even though Paolo couldn't be sure why his patient had died, | 0:45:33 | 0:45:37 | |
he still made plans for new operations. | 0:45:37 | 0:45:39 | |
In the US, he collaborated with the biotech company Harvard Bioscience. | 0:45:41 | 0:45:46 | |
Here's how the president of the company, David Green, presented the method. | 0:45:46 | 0:45:51 | |
The bioreact we build is actually no bigger than this. | 0:45:51 | 0:45:53 | |
It's about the size of a shoebox, | 0:45:53 | 0:45:55 | |
and inside there's a rotating part... | 0:45:55 | 0:45:57 | |
Green manufactured Macchiarini's bioreactor, | 0:45:57 | 0:46:01 | |
the plastic box with the tracheas bathed in stem cells. | 0:46:01 | 0:46:04 | |
For the viewers, David Green described | 0:46:04 | 0:46:07 | |
the method as if it was magic. | 0:46:07 | 0:46:10 | |
The plastic would come to life in no time. | 0:46:10 | 0:46:12 | |
What's it made out of? | 0:46:12 | 0:46:14 | |
It's actually made out of a plastic polymer material | 0:46:14 | 0:46:16 | |
that's a bit porous and so the cells can settle into those pours | 0:46:16 | 0:46:20 | |
inside the matrix and start to grow. It feels like home to them. | 0:46:20 | 0:46:23 | |
After a few days, the patient's own blood vessels actually grow into the | 0:46:23 | 0:46:28 | |
scaffold and make it really part of him. | 0:46:28 | 0:46:30 | |
And what's going on? Are they actually growing and multiplying? | 0:46:30 | 0:46:33 | |
Yes, that's exactly right. | 0:46:33 | 0:46:34 | |
But on the beach in 2012, everything sounded a little different. | 0:46:34 | 0:46:38 | |
What I was about to hear would come as a shock to me. | 0:46:43 | 0:46:47 | |
Paolo was explaining there was something wrong | 0:47:12 | 0:47:15 | |
with Andemariam's plastic trachea. | 0:47:15 | 0:47:17 | |
And not only with that one, but also with the new plastic tracheas. | 0:47:17 | 0:47:21 | |
And despite the problems being unsolved, | 0:47:22 | 0:47:25 | |
he intended to go ahead with new operations in just a few weeks. | 0:47:25 | 0:47:30 | |
I am quite unhappy about this, | 0:47:30 | 0:47:33 | |
because either we know exactly what's going on, | 0:47:33 | 0:47:36 | |
because otherwise... I mean... | 0:47:36 | 0:47:37 | |
Seven people in my lab have worked 24 hours a day for | 0:47:37 | 0:47:41 | |
the last three weeks doing biocompatibility, | 0:47:41 | 0:47:44 | |
and then this is shit now. | 0:47:44 | 0:47:45 | |
So I think that we need to redo everything again. | 0:47:45 | 0:47:48 | |
We lost two weeks | 0:47:48 | 0:47:50 | |
by doing this. | 0:47:50 | 0:47:52 | |
Macchiarini's team in Stockholm was desperately trying | 0:48:15 | 0:48:18 | |
to solve the problems. | 0:48:18 | 0:48:20 | |
And his haste to develop these techniques | 0:48:20 | 0:48:23 | |
seem to have become ingrained in his working practices. | 0:48:23 | 0:48:26 | |
If you have a patient that dies because of the new technology | 0:48:29 | 0:48:33 | |
then you always ask you... | 0:48:33 | 0:48:35 | |
Did I do something wrong? Do I have the right to continue? | 0:48:37 | 0:48:41 | |
Should I continue? | 0:48:41 | 0:48:42 | |
Um... | 0:48:43 | 0:48:44 | |
What should we do better? | 0:48:46 | 0:48:47 | |
So even with 25, these yellow... | 0:48:47 | 0:48:51 | |
..things are appearing. | 0:48:52 | 0:48:54 | |
It's very draining. | 0:48:56 | 0:48:57 | |
It's not a pleasant sensation at all. | 0:48:58 | 0:49:03 | |
Good. Thank you again for outstanding work. | 0:49:05 | 0:49:08 | |
But still, you learn only by doing. | 0:49:11 | 0:49:14 | |
It's going to be quite difficult to distinguish | 0:49:15 | 0:49:18 | |
the two measurements that we get. | 0:49:18 | 0:49:21 | |
Difficult but not impossible, right? | 0:49:21 | 0:49:23 | |
So he should do it, he must do it. | 0:49:25 | 0:49:28 | |
There is no changes or no choices. | 0:49:28 | 0:49:31 | |
I am seeing that we are still improving and we need to improve all the time. | 0:49:31 | 0:49:37 | |
And only by doing, we improve. | 0:49:37 | 0:49:39 | |
All these studies are ongoing. | 0:49:52 | 0:49:54 | |
This could be the future. | 0:49:54 | 0:49:56 | |
Thank you so much. | 0:49:56 | 0:49:58 | |
APPLAUSE | 0:49:58 | 0:50:00 | |
That's the kind of surgeon I want on my team. | 0:50:16 | 0:50:18 | |
If I'm on the wrong side of the knife, | 0:50:18 | 0:50:20 | |
I want a guy like Paolo Macchiarini trying to get me through this. | 0:50:20 | 0:50:22 | |
He's very experienced in transplantation, | 0:50:25 | 0:50:27 | |
experienced tracheal surgery, | 0:50:27 | 0:50:29 | |
so you don't say anything. | 0:50:29 | 0:50:31 | |
We need people like Paolo to force the issue, | 0:50:36 | 0:50:38 | |
to get a decision, to say, | 0:50:38 | 0:50:40 | |
"Let's just do this, even though we don't have all the answers." | 0:50:40 | 0:50:44 | |
The idea of this | 0:50:44 | 0:50:45 | |
trachea transplantation is something magic, really. | 0:50:45 | 0:50:49 | |
-He's the only one. -Yes. | 0:50:58 | 0:51:00 | |
But the result so far makes you hopeful? | 0:51:06 | 0:51:10 | |
Oh, yes. Of course, otherwise I would already have stopped. | 0:51:10 | 0:51:14 | |
Paolo had the support of some of the leading lights in his field. | 0:51:22 | 0:51:27 | |
And you can view the setbacks in more than one way. | 0:51:27 | 0:51:31 | |
Sure, two out of the three patients with plastic tracheas were dead, | 0:51:31 | 0:51:36 | |
but you might also point out that one of the three was alive, | 0:51:36 | 0:51:40 | |
and you could count that as a success to build on. | 0:51:40 | 0:51:43 | |
So how do you feel, physically? | 0:51:45 | 0:51:48 | |
I'm OK. | 0:51:48 | 0:51:49 | |
Always, we speak of relatively, | 0:51:49 | 0:51:53 | |
so from time to time it was going to be positive, going OK. | 0:51:53 | 0:51:59 | |
So I'm very optimistic in the future. | 0:51:59 | 0:52:03 | |
So, how is this day for you? | 0:52:03 | 0:52:06 | |
One year exactly after the operation of Andemariam. | 0:52:06 | 0:52:10 | |
I'm very pleased to see him doing so well and it is | 0:52:12 | 0:52:15 | |
a gratification for all the efforts that we have done | 0:52:15 | 0:52:19 | |
in the past and we continue to do. | 0:52:19 | 0:52:21 | |
So it is a major achievement | 0:52:21 | 0:52:23 | |
for every other patient that would need this type of transplantation. | 0:52:23 | 0:52:29 | |
What if the plastic method was fundamentally correct, | 0:52:31 | 0:52:35 | |
but that the patients had been too ill? | 0:52:35 | 0:52:38 | |
So far, Paolo had been allowed to use the plastic tracheas | 0:52:55 | 0:52:59 | |
in order to save lives. | 0:52:59 | 0:53:01 | |
Now he wanted to test this method on healthier and stronger patients | 0:53:03 | 0:53:07 | |
who were not in any immediate danger of dying. | 0:53:07 | 0:53:10 | |
Paolo had succeeded with something almost impossible. | 0:53:25 | 0:53:29 | |
Without extensive animal testing, | 0:53:29 | 0:53:31 | |
he got the go-ahead for using humans as guinea pigs. | 0:53:31 | 0:53:34 | |
He was to test the plastic tracheas in Russia, | 0:53:41 | 0:53:45 | |
on subjects who suffered from old injuries | 0:53:45 | 0:53:48 | |
but were not acutely ill or dying. | 0:53:48 | 0:53:51 | |
In order to choose the right subjects, | 0:53:53 | 0:53:55 | |
they trawled many candidates. | 0:53:55 | 0:53:57 | |
The German TV crew was there to record the operation. | 0:53:59 | 0:54:02 | |
This is Julia Tuulik, a teacher and former dancer from St Petersburg. | 0:54:05 | 0:54:10 | |
She won the chance to be the first experimental subject. | 0:54:13 | 0:54:17 | |
She was asked to record a video explaining why they should pick her. | 0:54:19 | 0:54:23 | |
Thank you for everybody that you came. | 0:56:15 | 0:56:17 | |
This is the final brainstorming before the transplantation and, | 0:56:17 | 0:56:21 | |
as a matter of fact, the patient, Julia, | 0:56:21 | 0:56:23 | |
tomorrow will be the first patient | 0:56:23 | 0:56:26 | |
entering a clinical trial. | 0:56:26 | 0:56:29 | |
So tomorrow we plan to do the | 0:56:29 | 0:56:31 | |
first in human ever done tracheal transplant | 0:56:31 | 0:56:34 | |
using bio-artificial scaffolds. | 0:56:34 | 0:56:36 | |
Julia was about to receive the world's fourth plastic trachea. | 0:57:06 | 0:57:10 | |
Her only living predecessor was in Iceland, Andemariam. | 0:57:15 | 0:57:18 | |
And at the Karolinska Hospital in Stockholm | 0:57:21 | 0:57:24 | |
there waited yet another patient. | 0:57:24 | 0:57:26 | |
By testing it on a patient as healthy as Julia, | 0:57:27 | 0:57:31 | |
would Macchiarini now be able to prove that his method was ingenious? | 0:57:31 | 0:57:35 | |
Would it be a success? | 0:57:37 | 0:57:39 | |
Nice to meet you. | 0:57:41 | 0:57:42 | |
Do they know the problem? | 0:57:43 | 0:57:45 | |
No, what is your problem? | 0:57:46 | 0:57:47 | |
Being at the cutting edge... | 0:58:05 | 0:58:06 | |
..you are always wrong, | 0:58:08 | 0:58:10 | |
until sooner, more likely later, you demonstrate the opposite. | 0:58:10 | 0:58:16 | |
Why should I give up? | 0:58:18 | 0:58:21 | |
I'm not the type to give up. | 0:58:21 | 0:58:22 |