710388Optimisation and Evaluation of a Novel Haemodialysis GraftClosedGRD Proof of ConceptInnovate UKThe project will produce an optimised novel non-degradable silk-based graft for dialysis to demonstrate the graft’s suitability for haemodialysis applications and will deliver prototypes for a first implantation in-vivo. There are 2 million patients treated for End Stage Renal Disease worldwide, a number increasing by 6-7% each year. Those treated by dialysis require blood filtering 3 times a week to replace kidneys function. The most effective approach is to create an arteriovenous fistula connecting an artery directly to a nearby vein in the patient’s forearm. Where the veins are unsuitable, a synthetic graft is implanted to connect the artery to the vein. However, current synthetic grafts on the market are inefficient, as a consequence of their material composition. Most grafts require 2 post-operative interventions a year to remain functional and over 75% are replaced within 2 years. By comparison, over 70% of fistulas are functioning after 18 months. This project will deliver a novel graft prototype using natural, commercially available silk proteins formed into a bio-mimetic tubular scaffold and with properties tailored to the specific requirements of haemodialysis. The optimised prototype will be tested to demonstrate its superior mechanical and biological characteristics and prepared for in-vivo evaluations. The biomimetic and inherently biocompatible graft will offer the first real alternative to the gold standard fistula. As it will be better integrated and lasts longer than current products, multiple post-operative interventions will be eliminated, significantly improving quality of life and reducing overall dialysis costs to the NHS and other healthcare providers worldwide.