TransMedics Group
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TransMedics Group (TMDX) investor relations material

TransMedics Group Q4 2025 earnings summary

Complete event summary combining all related documents: earnings call transcript, report, and slide presentation.
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Q4 2025 earnings summary24 Feb, 2026

Executive summary

  • Achieved record operational and financial performance in Q4 and full-year 2025, with Q4 revenue of $160.8M (up 32% year-over-year) and full-year revenue of $605.5M (up 37% year-over-year), driven by strong growth across core business segments and OCS platform expansion.

  • Net income for Q4 was $105.4M, including a significant one-time tax benefit from the release of a valuation allowance; full-year net income was $190.3M.

  • Completed 5,139 U.S. OCS cases in 2025, a 38% increase from 2024, and expanded the aviation fleet to 22 aircraft, covering 79% of NOP flight missions in Q4.

  • Announced new headquarters lease, adjacent land acquisition, and several key executive appointments.

  • Received FDA approvals for OCS ENHANCE Heart and DENOVO Lung trials.

Financial highlights

  • Q4 2025 revenue reached $160.8M, up 32% year-over-year and 12% sequentially; full-year 2025 revenue was $605.5M, up 37% year-over-year.

  • Q4 operating profit was $21.3M (13.2% margin); full-year operating profit was $108.6M (18% margin).

  • Q4 net income was $105.4M, including an $83.8M income tax benefit; full-year net income was $190.3M, both including significant tax benefits.

  • Ended 2025 with $488.4M in cash, up $22M from Q3, reflecting strong operating cash flow.

  • Gross margin for Q4 was 58% (down slightly year-over-year); full-year gross margin was 60%, up from 59% in 2024.

Outlook and guidance

  • 2026 revenue guidance set at $727–757M, representing 20–25% growth over 2025.

  • Gross margins expected to remain around 60% long-term, with some near-term pressure from international expansion and investments.

  • Operating margins expected to contract by up to 250 basis points in 2026 due to transitory investments, but projected to approach 30% by 2028 as investments normalize.

  • Strategic focus on accelerating heart and lung adoption in the US, launching NOP model in Europe, and preparing for OCS Kidney program launch.

  • Growth drivers include increased organ utilization, OCS adoption, service revenue expansion, and international market entry.

Core profitability excluding tax benefit
Aviation fleet expansion and NOP growth drivers
OCS Kidney program launch timeline and impact
ENHANCE Heart Part B competitive dynamic strategy
OCS Kidney's unique market position and timeline
Breakdown of transitory 2026 investments
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TD Cowen 46th Annual Health Care Conference2 Mar, 2026
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TD Cowen 46th Annual Health Care Conference2 Mar, 2026

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TransMedics Group, Inc., a commercial-stage medical technology company, engages in transforming organ transplant therapy for end-stage organ failure patients in the United States and internationally. It develops Organ Care System platform that enables the assessment of donor organ viability, the maintenance of donor organ function, and intervention in the organ procurement process for use in lung, heart, kidney and liver transplantations.

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