Worldwide, the number of patients with end-stage renal disease is projected to reach 5.4 million by 2030, and ~62% of these patients would receive dialysis. While a surgical connection made between an artery and a vein, known as fistula, is considered the gold standard, synthetic arteriovenous access grafts (e.g. ePTFE) are used when the patient is ineligible for a fistula (blocked, damaged or thin veins), or has a previously failed fistula. However, they display a significant risk of infection (11-15% annual hospitalisation rate), occlusion (~50% of all ePTFE grafts are abandoned after 1.5 years) and lack a regenerative ability.
We have developed a method for fabricating biological grafts from “densified” collagen hydrogel, through an approach which does not require the use of cells or decellularisation methods, supporting true off the shelf capability. Through our grafting technology we seek to replace synthetic grafts and demonstrate lower risks of infection, thrombosis and other complications, thereby leading to reductions in surgical interventions and demand for hospital access. Having successfully completed the small animal (rat) work using our grafts as an interposition vessel (artery-to-artery), the next step is to complete a validation in larger animals (pigs) where clinically-comparable surgeries and vascular access (artery-to-vein) can be performed. To de-risk the project and mitigate any risks to live animals, we are conducting ex vivo testing to assess graft compliance (against ePTFE and native vessels), and ability to support physiologic pressures when interposed with native tissue.
| Prof. Athina Markaki |
Department of Engineering |
| Prof. Sanjay Sinha |
Department of Medicine |
