TransMedics Group (TMDX) investor relations material

Adoption and growth in organ perfusion

• Machine perfusion for liver transplants has reached about 40% adoption, with ambitions to reach 80%-90% as more data is published and adoption spreads across centers.

• Major publications from thousands of liver registry cases are expected in the first half of 2026, supporting broader adoption.

• DCD liver adoption is around 60%, while DBD is in the mid-20s; significant opportunity remains as 70% of DCD livers are still discarded.

• Confident in achieving 10,000 transplants by 2028, with further growth potential from increased organ utilization and new center adoption.

• Growth levers include expanding into new centers and increasing utilization within existing centers, especially as reimbursement and administrative hurdles are addressed.

Clinical trials and technology development

• Enrollment has begun in new heart trials, with lung trials expected to start by early 2025; early momentum is positive.

• Trials aim to replicate liver success by enabling scheduled transplants for heart and lung, a first in the field.

• Superiority trials are designed to demonstrate value over traditional cold storage, with confidence in superior outcomes.

• Lung transplant market faces challenges post-COVID; current trials are seen as a last major effort to revitalize this segment before shifting focus to kidney.

• Gen3 OCS system is in development, featuring automation, improved reliability, and scalability for 20,000-30,000 transplants annually.

Financial strategy and operational efficiency

• Operating margin target is 30% by 2028, driven by growth, disciplined operating expenses, and margin protection.

• Efficiency improvements in jet operations are expected in 2026, with double-shifting pilots and increased case volume reducing the need for new planes.

• Increased organ volume across liver, heart, lung, and kidney is key to leveraging assets and improving profitability.

• Kidney transplants represent a major growth opportunity, with 23,000 performed and 10,000 rejected annually; OCS could reduce complications and increase utilization.

• Confident in financial position and ability to invest in growth despite increased competition.