Developing a regenerative artificial blood vessel for long-term kidney dialysis

Ziyu Wang, University of Sydney

Postdoctoral Fellowship

Years funded: 2025 - 2027

Kidney failure patients on dialysis need reliable and long-lasting access to their blood vessels. This access can be achieved using an arteriovenous graft (AVG), an artificial tube made of synthetic materials that connects an artery and a vein to create access points for dialysis. AVGs are necessary for patients who are suitable for arteriovenous fistulas or catheters. However, current AVGs often have issues like kinking (sharp bending that restricts blood flow), thrombosis (clotting that restricts blood flow), aneurysm formation (bulging that causes graft rupture), and slow maturation (slow arterial tissue growth that forbids repeated needle puncture). Our goal is to develop an AVG that can avoid these problems and grow into a new, functional blood vessel like natural ones, allowing for long-term repeated needle puncture without complications. To accomplish this goal, we will collaborate closely with leading scientists and clinicians in the field, ensuring a rigorous progression of the project through three distinct phases. In Phase I, we will leverage a biocompatible and biodegradable material previously developed by Dr Wang to fabricate an AVG. Then, through the use of advanced manufacturing and engineering techniques, we will optimise this AVG to address current challenges and enhance its overall performance. In phase II, we will test this improved AVG in rats with kidney disease to show its ability to regenerate and mature over 4 months. Finally, in phase III, we will test the AVG in sheep for 8 months to assess its safety, regeneration, maturation, and ability to handle repeated needle puncture, mimicking a long-term dialysis treatment.

The success of this project will produce a regenerative AVG that addresses current problems of kinking, thrombosis, aneurysm formation, and slow maturation, allowing patients to have reliable dialysis access for a long time without complications. This could change how we approach dialysis care, shifting from a ‘Fistula First’ approach to a ‘Graft First’ paradigm.