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Inclusion Criteria:

* (1) Age ≥18 years and ≤80 years, male or female;
* (2) Diagnosed with end-stage renal disease (ESRD) requiring maintenance hemodialysis;
* (3) Requiring establishment of a long-term hemodialysis vascular access but unable to have a autologous arteriovenous fistula (AVF) created;
* (4) Assessed by the investigator as suitable for implantation of an arteriovenous graft (AVG) in the upper extremity;
* (5) Able to understand the purpose of the study, voluntarily participating and providing signed informed consent(ICF), and willing to comply with all scheduled follow-up assessments.

Exclusion Criteria:

* (1) Known or suspected history of allergy to heparin, alcohol, or bovine-derived products;
* (2) Planned to undergo renal transplantation or transition to peritoneal dialysis within 1 year;
* (3) Hemoglobin concentration \<60 g/L, or platelet count \<60 × 10⁹/L;
* (4) Left ventricular ejection fraction (LVEF) \<30%;
* (5) Severe cardiac disease, including New York Heart Association (NYHA) Class III-IV severe heart failure, or history of myocardial infarction, unstable angina, or sustained ventricular tachyarrhythmia requiring continuous treatment within 6 months prior to enrollment;
* (6) History of stroke within 1 month prior to enrollment;
* (7) Uncontrolled or poorly controlled diabetes mellitus (preoperative glycated hemoglobin \>10%);
* (8) Immunodeficiency disorders, or current treatment with corticosteroids (prednisone-equivalent dose ≥10 mg) or immunosuppressive agents (e.g., sirolimus, mycophenolate mofetil, cyclosporine, cyclophosphamide, tacrolimus);
* (9) Malignancy or other severe systemic disease with a life expectancy of \<12 months;
* (10) Heparin-induced thrombocytopenia type II (HIT-2) or other contraindications to heparin use;
* (11) Aspartate aminotransferase (AST) or alanine aminotransferase (ALT) \>2 × upper limit of normal (ULN);
* (12) Coagulation disorders (activated partial thromboplastin time \[APTT\] or prothrombin time \[PT\] \>1.5 × ULN);
* (13) Systemic or surgical site infection (white blood cell \[WBC\] count \>15 × 10⁹/L);
* (14) Baseline hypotension, or frequent hypotensive episodes within the past month (frequency ≥5 episodes/month, with hypotension defined as systolic blood pressure \<90 mmHg or diastolic blood pressure \<60 mmHg);
* (15) Hypercoagulable state, or history of ≥2 episodes of deep vein thrombosis or peripheral vascular thrombosis not related to dialysis access;
* (16) Known ipsilateral central venous stenosis, or clinical symptoms/signs suggestive of central venous stenosis confirmed by imaging;
* (17) Severe mental disorders that preclude cooperation with the study protocol;
* (18) Pregnant or lactating women, or women of childbearing potential who plan to conceive during the trial and are unwilling to use effective contraception;
* (19) Currently enrolled in another drug or medical device clinical trial and not yet completed the study;
* (20) Any other conditions that, in the investigator's opinion, make the patient unsuitable for participation in this clinical trial.

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