TransMedics Group (TMDX) Q3 2025 earnings summary

Executive summary

• Achieved Q3 2025 revenue of $143.8 million, up 32.2% year-over-year, driven by increased OCS utilization, especially in liver and heart transplants through the National OCS Program (NOP), with strong cash generation.

• Net income reached $24.3 million, or $0.66 per diluted share, representing 17% of revenue, a significant increase from $4.2 million in Q3 2024.

• Gross margin improved to 59%, up 2.9 percentage points year-over-year.

• Expanded aviation fleet to 22 aircraft by October 2025, supporting logistics for organ transport and 78% coverage of air transport missions.

• Announced a strategic collaboration with Mercedes-Benz to deploy a dedicated fleet of vehicles for organ transportation in Italy.

Financial highlights

• U.S. transplant revenue was $139 million, up 32% year-over-year; product revenue was $88 million (+33% YoY, -9% sequentially); service revenue was $56 million (+31% YoY, -8% sequentially).

• By organ: liver $108 million (+41% YoY), heart $27 million (+14% YoY), lung $4 million (+5% YoY).

• Logistics service revenue reached $27.2 million (+35% YoY).

• Net income for Q3 was $24.3 million (+477% YoY, -30% sequentially); EPS $0.71, diluted EPS $0.66.

• Cash and equivalents increased to $466.2 million at quarter-end, up $65.6 million sequentially and 38.5% since year-end.

Outlook and guidance

• Full-year 2025 revenue guidance raised to $595–$605 million, representing 36% growth over 2024 at the midpoint.

• Gross margin expected to remain around 60% in coming years, with temporary pressure possible as international expansion continues.

• Operating margin expansion of at least 750 basis points expected for 2025, with a long-term target of 30% by 2028.

• Management expects continued growth in revenue and gross margin over the long term, driven by NOP expansion and international adoption.

• 2026 guidance to be provided after year-end, with expectations for continued growth.