Comparison of the Human Acellular Vessel (HAV) With ePTFE Grafts as Conduits for Hemodialysis

This is a Phase 3, prospective, multicenter, multinational, open-label, randomized, two-arm,
comparative study. Subjects who sign informed consent would undergo study-specific screening
assessments within 35 days from the day of informed consent.

On the day of surgery (Day 0), subjects could still be undergoing screening assessments, such
as confirmation of inclusion/exclusion criteria, to determine their eligibility before they
are randomized in the study. Eligible study subjects will be randomized to receive either a
HAV or one of two commercially available ePTFE grafts and followed to 24 months
post-implantation at routine study visits regardless of patency status. After 24 months,
subjects with a patent study conduit will be followed (while the study conduit remains
patent) for up to 5 years (60 months) post implantation at routine study visits.

Inclusion Criteria:

- Subjects with ESRD who are not, or who are no longer, candidates for creation of an
autologous AV fistula and therefore need placement of an AV graft in the arm (upper-
or forearm) to start or maintain hemodialysis therapy.

- Either on hemodialysis or expected to start hemodialysis within 12 weeks of study
conduit implantation.

- At least 18 years of age at Screening.

- Suitable anatomy for implantation of straight or looped conduits in either the forearm
or upper arm (not crossing the elbow).

- Hemoglobin ≥8 g/dL and platelet count ≥100,000 cells/mm3 prior to Day 0 (within 35
days).

- Other hematological and biochemical parameters within a range consistent with ESRD
prior to Day 0 (within 35 days).

- Adequate liver function prior to Day 0 (within 35 days), defined as:

- ≤2x upper limit of normal (ULN) for serum bilirubin, aspartate transaminase
(AST), alanine transaminase (ALT), and alkaline phosphatase

- ≤1.5 for International Normalized Ratio (INR) or prothrombin time (PT) ≤ 18
seconds unless the subject is taking an anticoagulant at the time

- Female subjects must be either:

- Of non-childbearing potential, which is defined as post-menopausal (at least 1
year without menses prior to Screening) or documented surgically sterile or post
hysterectomy (at least 1 month prior to Screening)

- Or, of childbearing potential, in which case:

- Must have a negative urine 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:

- Established use of oral, injectable or implanted hormonal methods of
contraception

- Placement of an intrauterine device or intrauterine system

- Barrier methods of contraception: condom or occlusive cap (diaphragm or
cervical/vault caps) with spermicidal foam/ gel/ film/ cream/
suppository

- Subject, or legal representative, able to communicate effectively with investigative
staff, 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.

Exclusion Criteria:

- History or evidence of severe peripheral vascular disease in the intended arm for
implantation.

- Known or suspected central vein obstruction on the side of planned implantation,
unless corrected before study conduit implantation.

- Treatment with any investigational drug or device within 60 days prior to study entry
(Day 0) or ongoing participation in a clinical trial of an investigational product.

- Cancer that is actively being treated with a cytotoxic agent.

- Documented hyper-coagulable state.

- Bleeding diathesis.

- Active clinically significant autoimmune disease.

- Anticipated renal transplant within 6 months.

- Venous outflow from study conduit cannot be placed more centrally than any previous
failed access.

- Active local or systemic infection (white blood cells [WBC] > 15,000 cells/mm3 at
Screening). If the infection resolves, the subject must be at least one week post
resolution of that infection before implantation.

- Known serious allergy to planned antiplatelet agent.

- Pregnant women, or women intending to become pregnant during the course of the trial.

- Any other condition which in the judgment of the investigator would preclude adequate
evaluation of the safety and efficacy of the study conduit.

- Previous enrollment in this study or any other study with the HAV.

- Employees of Humacyte and employees or relatives of the investigator.