A Phase 3 Randomized Study to Compare the Efficacy and Safety of the Humacyte Acellular Tissue Engineered Vessel (ATEV) With That of an Autogenous Arteriovenous Fistula (AVF) in Female Patients With End-Stage Renal Disease Requiring Hemodialysis
The goal of this clinical trial is to compare the number of catheter-free days (CFD) and the rate and severity of any dialysis access-related infections between the ATEV and AVF groups over 12 months in patients with end-stage renal disease (ESRD) needing hemodialysis (HD). Participants will be stratified by location of the vascular access (forearm versus upper arm) and by type of AVF creation procedure planned by the surgeon at randomization (1-stage AVF versus 2-stage AVF). The comparator is an upper extremity arterio-venous fistula (AVF) for HD access surgically created per the institution's Standard of Care (SoC).
• Female patients with ESRD, currently receiving hemodialysis via dialysis catheter and who are candidates for the creation of an AVF (see Inclusion Criterion #4 below) or implantation of an ATEV for HD access.
• Patients who plan to undergo HD at a dialysis unit of a participating dialysis provider for at least 12 months after SA creation.
• Patients aged ≥ 18 years at Screening.
• Suitable anatomy for creation of a forearm or upper arm AVF and for implantation of straight, curved, or looped ATEV in either the forearm or upper arm.
• NOTE: Suitable anatomy will be determined by both physical examination and ultrasound imaging or vessel imaging modality in addition to consideration of all vascular sites available, prior access failure, future access sites and possibilities to preserve patients' future alternate accesses. Vessel mapping is the preferred method to assess the vascular anatomy, and will evaluate the following attributes during Screening:
⁃ Vein diameter
⁃ Arterial diameter
⁃ Presence of arterial calcification
⁃ Depth of the intended fistula conduit from the surface of the skin
⁃ Central vein patency
⁃ Previous vascular access location The ultimate decision of anatomic suitability belongs to the surgeon and/or the investigator.
• Hemoglobin ≥ 7 g/dL and platelet count ≥ 100,000 /mm3
• Patients must either:
∙ Be of non-childbearing potential, which is defined as post-menopausal (at least 1 year without menses prior to Screening) or documented surgically sterile (i.e., total hysterectomy or tubal ligation, or complete bilateral oophorectomy) at least 1 month prior to Screening.
‣ Or, if of childbearing potential:
• Must have a negative serum pregnancy test at Screening, and
• Must agree to use at least one form of the following birth control methods for the duration of the study:
• i. Established use of oral, injectable or implanted hormonal methods of contraception.
• ii. Placement of an intrauterine device or intrauterine system at least 5 days prior to Screening.
• iii. Barrier methods of contraception: condom or occlusive cap (diaphragm or cervical/vault caps) with spermicidal foam/ gel/ film/ cream/ suppository.
• Patient or their legal representative can communicate effectively with investigative staff, is competent and willing to give written informed consent, and able to comply with entire study procedures including all scheduled follow-up visits.
• Life expectancy of at least 1 year confirmed by Charlson Comorbidity Index ≤ 9.