In December 2018, Sweden decided to reopen a previously halted investigation into three cases. Additional documentary evidence was obtained and more interviews were conducted with individuals in Sweden, Belgium, Great Britain, the United States and Spain.

The former surgeon appeared in court in Solna on Wednesday, but is expected to testify on Friday. His lawyer, Björn Hurtig, believes Macchiarini’s former employer, the prestigious Swedish Karolinska Institute, should be held responsible, Swedish broadcaster SVT said.

Macchiarini was fired from Karolinska Institute in March 2016 for violation of medical ethics after he was accused of falsifying his resume and misrepresenting his job.

When Macchiarini’s first trachea transplant was featured in the medical journal Lancet in 2008, it was hailed as a breakthrough in regenerative medicine. Macchiarini’s new airway — made in part using patient stem cells — would usher in a new era in which new organs could be created in the lab.

Despite an independent commission in Sweden discovering numerous problems in Macchiarini’s work, the Lancet has so far refused to retract the investigation.

Macchiarini had previously disputed the allegations, saying they were false.

He operated on 20 Macchiarini patients to give them an artificial trachea – from countries such as Spain, Russia, Iceland, Britain and the US. Critics say Macchiarini circumvented medical ethics to perform dangerous procedures with no proven benefit and that he used descriptions of his patients had made up’ conditions.

In 2019, an Italian court sentenced Macchiarini to 16 months in prison for forging documents and abuse of office.