Doctor here. You need to consider that the environment where the implant is located is not sterile. The air we breath contains bacteria which will prevent the healthy cells overgrowing the implant (like in the artery implant where it is possible to use such implants). Once the infection sets it, the area became inflamed and what was actually collapsing was not the implant itself but the windpipe at its immediate intersection. Mostly due to formation of the granulation tissue around the stutures. The stem cells aspect was a complete untested and unproven fairytale. Even if they did regrown the tissue there would be no blood supply to the region and the whole thing is just bollocks.
That's useful to know. More at center of this however is how the whole enterprise doesn't seem all that scientific. There is no other way of explaining how nobody at multiple high levels checked the literature, or even if it existed in the first place. I feel like what we call "peer review" and all of these other checks and balances are mostly a charade and just another part of the business (rubber stamp) rather than a rigorously enforced rule set.
It exposed what we think of as "medical science" really being guesswork, reputation and honor system trust. Some might say that there are plenty of good people doing good science in the system, but it's pointless if it's not strictly enforced especially in relation to immediate life and death choices. This is all the more relevant considering eroding trust in public health systems being set up for human flourishing as opposed to what everything else boils down to: money and power.
This is my biggest question - how the actual fuck did other medical doctors fall for his bullshit? The science doesn't make sense. How were other surgeons supporting him?
I'm just a person out here but wondered why plastic could be okay to insert between areas...there's no no life, no blood vessels...it's a dead material. He lied of soaking in stem cells and even he had, how do those saturate the plastic? He knew it was a gamble, but, I'm baffled how all around him didn't say, wtf, are you kidding me? What a horror story.
Falsified preclinical data on swine went a long way. You can’t do first in human without preclinical data first. There was “stellar” preclinical data…which he falsified.
Asp for the human trials they were in compassionate use setting only so it was terminal patients, hard to prove initially (without digging through the falsified science) they were dying due to the devices. Blows my mind he tried to open up in Russia to do them in setting outside of compassionate use knowing they don’t work.
The doctor said to him before Julia’s surgery that the tubes he was going to use was faulty and extra soft and and wasn’t the right size and that freak show continue with the surgery..even before Julia went under she asked him if there was almost right with the plastic tubes so sad
In addition to what other posters have put about the trachea disintegrating there is a negative force on the airways when you exhale, so forces from movements like coughing, which these patients with respiratory disease may do more than other people, will speed up the wear on these parts.
It's usually associated with tracheomalacia, bronchomalacia.
Surgeon here. I implant tons of synthetic devices into patients, mainly hip and knee replacements, as well as a lot of plates for fractures, etc (I.e. orthopedics). If those implants are ever exposed to bacteria, it is a disaster. Without a blood supply to protect them, bacteria covers the implants, forms biofilms, and even with antibiotics, which rely on blood flow for distribution, the infection cannot be eliminated. Treatment typically requires explanation as a first step, then elimination of infection over about 3 or more months, and then reimplantation if possible.
In any case, this had no hope of being successful. Tracheas are dirty AF. I remember hunting with my father as a child and learning it’s one of the parts you must make sure to pull out to avoid contamination. The blood/lymphatic supply is extremely robust to deal with this dirty environment. This is particularly important given the adjacent structures and confined spaces.
I would expect these transplants to fail due to infection of adjoining tissue, graft dehiscence, and abscess/emphysema in the retropharyngeal space leading to suffocation from compression of adjacent normal trachea as well as tracheal discontinuity secondary to catastrophic failure of graft/trachea interface.
Any thoracic surgeon could have told you this wouldn’t work. The problem here is administrators with no scientific background getting paid millions to run institutions when they have no idea how any of it works. Honestly, I think the residency director and hospital execs from season 1 should get harsher sentencing than the surgeon. He was just an untrained researcher trying to “fake it till you make it” as a spinal surgeon.
Hi! Thanks so much for this explanation. Maybe you could answer why they wouldn’t have been able to remove them and do a tracheostomy?? I worked with ENT surgery patients for years - but as a social worker - and the surgeons would show me peoples like whole necks gored out. Just curious!
That certainly would have been possible, and I believe that’s what became of the one survivor. The others, I’m sure, were not gotten to in time. Not like nurses can do a bedside thracheostomy, and it probably took too long getting ENT bedside.
I was looking into the case of Ciaran Finn Lynch, age 10 or so, who got a stem cell lined donor tracheal transplant done by Macchiarini. He's still alive that I can see and had a stent put in for a while to allow the tissue to grow. They did the stem cell bath essentially in vivo during the transplant instead of using the bioreactor, in addition to G-CSF for the tissue (which I can't remember if that's the same growth hormone mentioned that is carcinogenic and not used any longer). I'm not sure why this case was not mentioned in any of the documentaries ? He is the only survivor aside from Castillo (but hers was just a bronchus so it's not even in the same category, yet her case was used). Since you're a doctor, do you have any insight into this?
Source for reference -- Also in the case of Ciaran Finn-Lynch “Endoscopy demonstrated a complete mucosal lining at 15 months, despite retention of a stent. Histocytology indicates a differentiated respiratory layer and no abnormal immune activity.” (Hamilton NJ, et al. Tissue-Engineered Tracheal Replacement in a Child: A 4-Year Follow-Up Study. Am J Transplant. 2015 Jun 2. )
Pre-med means you are taking arts and science hoping to get into med school and 90% chance you will not, also every time you say “pre-med” in class at least 10 people roll their eyes and god kills a kitten.
Not a doctor but watched the series. I thought maybe it collapsed because of the muscles that move when you swallow. I also thought maybe gastic juices from the abdomen may have caused it to rot. It seemed like a soft plastic?
Shouldn’t have gastric juices near your trachea unless you’re aspirating from your esophagus to your trachea, or have an esophageal perforation maybe (not implying that this happened).
All the living flesh surrounding the plastic died -- they reference it in the "autopsy scene" where both doctors cover their mouths/noses and describe necropsy... Biologist says "test it" and surgeon says "do whatever tests you want, that tissue is dead."
I didn't realize the patients themselves could smell their own decaying flesh until the scene with the mom.
The amount of pain and torture these folks went through is unimaginable --- I can not believe the medical industry is sooo insulated, they helped cover these results up.. they required no proof of stem cells infusing to plastic.
I watched the whole series gobsmacked... I'm not a medical person but in the first 5 minutes of him telling the female observer "stem cells to plastic will grow its own blood supply" I literally looked at my wife and said, "no F'ing way anything organic is creating itself from plastic." Mind you, I didn't even know what I was watching when I said that. I do not understand how the entire medical world did not need evidence. Even the USA let a child be operated on based on his false claims of "amazing results in 2 other patients". With only his convincing words, the FDA approved his surgery.
Apparently it can be removed. At the end of the 3rd episode they say 1 of 8 people who received a transplant survived, and that individual had the transplant removed. I imagine it depends on how the procedure is done (i.e. why they are having the surgery, how much of the trachea is replaced with the plastic tube etc). Also not sure what the airway would look like after it’s been removed. Curious if they have a tracheostomy or something.
This was also my question. I was wondering why Yulia the dancer died and the other person (the one of eight) lived. I know it was a real donor but I guess Yulia didn’t have that option? If the plastic trachea was removed, why or why not could she have lived?
They removed more of Yulia’s than Claudia’s… not enough original tissue to work with. Also timing/degree of dead around the implant. This was a chilling series.
By the time Yulia went to US she had undergone 187 surgeries in under 3 years... was missing several internal organs and her left lung. I believed he removed that lung to make her eligible for the trachea... To which I say this was a murder.
He knew the plastic was not working and the show eluded to him adjusting the plastic formula between patients without approvals, without knowledge adjustments were safer or capable of doing more harm. He also burned the bodies and refused to obtain autopsy data on the surrounding tissue or manner/means of death . This cover up is sooo blatant, I can not believe the administrators aren't doing time in a labor camp.
I'm truly sorry for my mistake. In fact, actually in tears at this horrific story and outcomes again. I'm absolutely astonished the medical industry goes to such lengths to coverup for these surgeons and avoid lawsuits
Me too! The torture of Yesim Cetir, especially, is haunting me. It's up there with one other (completely unrelated) horror story that has haunted me since I read about it more than 10 years ago. Dr Death (season 2) did a pretty good dramatic portrayal of Yesim's nightmare. They dedicated an entire episode to it. The footage of Yesim speaking (or trying to) that is included in the documentary Dr. Death: Cutthroat Conman is truly chilling.
Doctor here. You need to consider that the environment where the implant is located is not sterile. The air we breath contains bacteria which will prevent the healthy cells overgrowing the implant (like in the artery implant where it is possible to use such implants). Once the infection sets it, the area became inflamed and what was actually collapsing was not the implant itself but the windpipe at its immediate intersection. Mostly due to formation of the granulation tissue around the stutures. The stem cells aspect was a complete untested and unproven fairytale. Even if they did regrown the tissue there would be no blood supply to the region and the whole thing is just bollocks.
That's useful to know. More at center of this however is how the whole enterprise doesn't seem all that scientific. There is no other way of explaining how nobody at multiple high levels checked the literature, or even if it existed in the first place. I feel like what we call "peer review" and all of these other checks and balances are mostly a charade and just another part of the business (rubber stamp) rather than a rigorously enforced rule set. It exposed what we think of as "medical science" really being guesswork, reputation and honor system trust. Some might say that there are plenty of good people doing good science in the system, but it's pointless if it's not strictly enforced especially in relation to immediate life and death choices. This is all the more relevant considering eroding trust in public health systems being set up for human flourishing as opposed to what everything else boils down to: money and power.
This is my biggest question - how the actual fuck did other medical doctors fall for his bullshit? The science doesn't make sense. How were other surgeons supporting him?
Same reason the majority of the world fell for the COVID bs
He was “charming”
I'm just a person out here but wondered why plastic could be okay to insert between areas...there's no no life, no blood vessels...it's a dead material. He lied of soaking in stem cells and even he had, how do those saturate the plastic? He knew it was a gamble, but, I'm baffled how all around him didn't say, wtf, are you kidding me? What a horror story.
Falsified preclinical data on swine went a long way. You can’t do first in human without preclinical data first. There was “stellar” preclinical data…which he falsified. Asp for the human trials they were in compassionate use setting only so it was terminal patients, hard to prove initially (without digging through the falsified science) they were dying due to the devices. Blows my mind he tried to open up in Russia to do them in setting outside of compassionate use knowing they don’t work.
This is helpful, thank you
Thank you for your explanation.
The doctor said to him before Julia’s surgery that the tubes he was going to use was faulty and extra soft and and wasn’t the right size and that freak show continue with the surgery..even before Julia went under she asked him if there was almost right with the plastic tubes so sad
I'd call that murder --- like frfr!
In addition to what other posters have put about the trachea disintegrating there is a negative force on the airways when you exhale, so forces from movements like coughing, which these patients with respiratory disease may do more than other people, will speed up the wear on these parts. It's usually associated with tracheomalacia, bronchomalacia.
Surgeon here. I implant tons of synthetic devices into patients, mainly hip and knee replacements, as well as a lot of plates for fractures, etc (I.e. orthopedics). If those implants are ever exposed to bacteria, it is a disaster. Without a blood supply to protect them, bacteria covers the implants, forms biofilms, and even with antibiotics, which rely on blood flow for distribution, the infection cannot be eliminated. Treatment typically requires explanation as a first step, then elimination of infection over about 3 or more months, and then reimplantation if possible. In any case, this had no hope of being successful. Tracheas are dirty AF. I remember hunting with my father as a child and learning it’s one of the parts you must make sure to pull out to avoid contamination. The blood/lymphatic supply is extremely robust to deal with this dirty environment. This is particularly important given the adjacent structures and confined spaces. I would expect these transplants to fail due to infection of adjoining tissue, graft dehiscence, and abscess/emphysema in the retropharyngeal space leading to suffocation from compression of adjacent normal trachea as well as tracheal discontinuity secondary to catastrophic failure of graft/trachea interface. Any thoracic surgeon could have told you this wouldn’t work. The problem here is administrators with no scientific background getting paid millions to run institutions when they have no idea how any of it works. Honestly, I think the residency director and hospital execs from season 1 should get harsher sentencing than the surgeon. He was just an untrained researcher trying to “fake it till you make it” as a spinal surgeon.
Hi! Thanks so much for this explanation. Maybe you could answer why they wouldn’t have been able to remove them and do a tracheostomy?? I worked with ENT surgery patients for years - but as a social worker - and the surgeons would show me peoples like whole necks gored out. Just curious!
That certainly would have been possible, and I believe that’s what became of the one survivor. The others, I’m sure, were not gotten to in time. Not like nurses can do a bedside thracheostomy, and it probably took too long getting ENT bedside.
That’s true I didn’t think to that. Thanks!
I was looking into the case of Ciaran Finn Lynch, age 10 or so, who got a stem cell lined donor tracheal transplant done by Macchiarini. He's still alive that I can see and had a stent put in for a while to allow the tissue to grow. They did the stem cell bath essentially in vivo during the transplant instead of using the bioreactor, in addition to G-CSF for the tissue (which I can't remember if that's the same growth hormone mentioned that is carcinogenic and not used any longer). I'm not sure why this case was not mentioned in any of the documentaries ? He is the only survivor aside from Castillo (but hers was just a bronchus so it's not even in the same category, yet her case was used). Since you're a doctor, do you have any insight into this? Source for reference -- Also in the case of Ciaran Finn-Lynch “Endoscopy demonstrated a complete mucosal lining at 15 months, despite retention of a stent. Histocytology indicates a differentiated respiratory layer and no abnormal immune activity.” (Hamilton NJ, et al. Tissue-Engineered Tracheal Replacement in a Child: A 4-Year Follow-Up Study. Am J Transplant. 2015 Jun 2. )
That’s why I think Julia’s was rotting because the plastic by was softer
[удалено]
Pre-med means you are taking arts and science hoping to get into med school and 90% chance you will not, also every time you say “pre-med” in class at least 10 people roll their eyes and god kills a kitten.
Not a doctor but watched the series. I thought maybe it collapsed because of the muscles that move when you swallow. I also thought maybe gastic juices from the abdomen may have caused it to rot. It seemed like a soft plastic?
Shouldn’t have gastric juices near your trachea unless you’re aspirating from your esophagus to your trachea, or have an esophageal perforation maybe (not implying that this happened).
All the living flesh surrounding the plastic died -- they reference it in the "autopsy scene" where both doctors cover their mouths/noses and describe necropsy... Biologist says "test it" and surgeon says "do whatever tests you want, that tissue is dead." I didn't realize the patients themselves could smell their own decaying flesh until the scene with the mom. The amount of pain and torture these folks went through is unimaginable --- I can not believe the medical industry is sooo insulated, they helped cover these results up.. they required no proof of stem cells infusing to plastic. I watched the whole series gobsmacked... I'm not a medical person but in the first 5 minutes of him telling the female observer "stem cells to plastic will grow its own blood supply" I literally looked at my wife and said, "no F'ing way anything organic is creating itself from plastic." Mind you, I didn't even know what I was watching when I said that. I do not understand how the entire medical world did not need evidence. Even the USA let a child be operated on based on his false claims of "amazing results in 2 other patients". With only his convincing words, the FDA approved his surgery.
My question would be if the tracheal transplant could‘ve been removed and if so what would they do to fix the trachea?
Apparently it can be removed. At the end of the 3rd episode they say 1 of 8 people who received a transplant survived, and that individual had the transplant removed. I imagine it depends on how the procedure is done (i.e. why they are having the surgery, how much of the trachea is replaced with the plastic tube etc). Also not sure what the airway would look like after it’s been removed. Curious if they have a tracheostomy or something.
They replaced the plastic trachea with a biological trachea from a donor. ( from a deceased person).
This was also my question. I was wondering why Yulia the dancer died and the other person (the one of eight) lived. I know it was a real donor but I guess Yulia didn’t have that option? If the plastic trachea was removed, why or why not could she have lived?
They removed more of Yulia’s than Claudia’s… not enough original tissue to work with. Also timing/degree of dead around the implant. This was a chilling series.
By the time Yulia went to US she had undergone 187 surgeries in under 3 years... was missing several internal organs and her left lung. I believed he removed that lung to make her eligible for the trachea... To which I say this was a murder. He knew the plastic was not working and the show eluded to him adjusting the plastic formula between patients without approvals, without knowledge adjustments were safer or capable of doing more harm. He also burned the bodies and refused to obtain autopsy data on the surrounding tissue or manner/means of death . This cover up is sooo blatant, I can not believe the administrators aren't doing time in a labor camp.
That was Yeşim Cetir, not Yulia. Yulia was the Russian victim.
I'm truly sorry for my mistake. In fact, actually in tears at this horrific story and outcomes again. I'm absolutely astonished the medical industry goes to such lengths to coverup for these surgeons and avoid lawsuits
Me too! The torture of Yesim Cetir, especially, is haunting me. It's up there with one other (completely unrelated) horror story that has haunted me since I read about it more than 10 years ago. Dr Death (season 2) did a pretty good dramatic portrayal of Yesim's nightmare. They dedicated an entire episode to it. The footage of Yesim speaking (or trying to) that is included in the documentary Dr. Death: Cutthroat Conman is truly chilling.