TransMedics Group, Inc. is on a mission to change the landscape of organ transplantation. Using its proprietary Organ Care System (OCS) and National OCS Program (NOP), the company not only enables organ preservation under near-physiologic conditions but also integrates end-to-end transplant logistics including aviation.
As of May 31, 2025, TransMedics has transitioned from loss-making to profitability, expanded into aviation, entered Europe, and now stands at the forefront of a $23B+ global market.
📊 1. Financial Performance: A 5-Year Revenue Explosion
Here’s the most complete breakdown of TransMedics’ quarterly and annual financial transformation:
📌 Full Financial History: 2020–Q1 2025
| Year/Quarter | Revenue | Net Income | EBITDA / Operating Profit | Gross Margin |
|---|---|---|---|---|
| Q1 2025 | $143.5M | $25.7M | $27.4M (19% margin) | ~59.2% |
| Q4 2024 | $121.6M | $6.9M | $8.6M (7% margin) | ~59.2% |
| Q1 2024 | $96.9M | $12.2M | Not Reported | Not Disclosed |
| 2024 (FY) | $441.5M | $35.5M | Not detailed | ~59.2% |
| 2023 (FY) | $241.6M | ($25.0M) | Not detailed | ~59.0% |
| 2022 | $93.5M | ($36.2M) | Not detailed | N/A |
| 2021 | $30.3M | ($44.2M) | Not detailed | N/A |
| 2020 | $25.6M | Loss | Not detailed | N/A |
➡️ Key Transformation: From $25M revenue in 2020 to $441M in 2024 — an almost 18x increase in just four years.
➡️ Profitability Milestone: $35.5M net profit in 2024, a turnaround from a $25M net loss in 2023.
✈️ 2. Business Model Evolution: From Devices to Full-Service Logistics
🩺 OCS Case Volume
| Year | OCS Cases | YoY Growth |
|---|---|---|
| 2021 | ~1,000 | – |
| 2023 | 2,347 | +135% |
| 2024 | 3,715 | +58% |
OCS CAGR (2021–2024): Over 50%
TransMedics now facilitates real-time, on-demand organ transport, integrating device use with transplant logistics.
✈️ Aviation Fleet
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Owns 19 aircraft as of Dec 2024, expanding to 22 by end-2025
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Internal transport now handles 78% of NOP missions (up from 75% in Q4 2024)
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Reduces reliance on third-party providers ➜ better margin control
🌍 Geographic Expansion
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🇺🇸 Core market is U.S.
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🇮🇹 Italy-based manufacturing to serve Europe
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Asia expansion considered post-2026
🔮 3. Future Outlook & Projections
📈 Revenue and EPS Forecast
| Metric | 2024 Actual | 2025 Forecast |
|---|---|---|
| Revenue | $441.5M | ~$585M (+30% YoY) |
| EPS | $1.01 | $1.20–$1.50 |
| Long-Term Rev | – | $1.3B by 2028 goal |
Key Growth Driver: Targeting 10,000 OCS cases/year in the U.S. by 2028, up from 3,715 in 2024.
🧪 4. Innovation & Clinical Programs
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🔬 OCS Heart & Lung Trials (Next-gen models launching in 2025)
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🧪 OCS Kidney development underway – could add $5–7B to TAM
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📡 Digital platform launch (2025) for real-time tracking & center integration
💰 5. Debt Management & Financial Health
| Financial Metric | Value |
|---|---|
| Debt-to-Equity | 2.27 (moderate) |
| Convertible Notes | 1.5%, due 2028 |
| Interest Burden | Low |
| Cash (Q3 2023) | ~$427M (likely lower in 2025) |
| Operating Profit (Q1 25) | $27.4M ➜ positive cash flow |
✅ Conclusion: No repayment pressure until 2028. Strong cash flow covers logistics and R&D needs.
🌍 6. Market Opportunity: A $23B+ TAM Awaits
| Segment | TAM Estimate |
|---|---|
| U.S. Core (Heart, Lung, Liver) | ~$10B |
| Global (Existing) | ~$23B |
| OCS Kidney Future | +$5–7B |
🧱 7. Competitive Landscape & Risks
🥇 Strengths:
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First-mover in warm perfusion + air logistics
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Fast-growing market share: 20.9% (2024) from 13.8% (2023)
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Proprietary integration of device + aircraft + platform
⚠️ Risks:
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Regulatory history: 2024 Citizen Petition (resolved)
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Competitors: OrganOx, Paragonix (Getinge-owned)
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Stock volatility: Beta 2.13; 52-week drop: -23.49%
📉 8. Technical Analysis (as of May 31, 2025)
| Metric | Reading |
|---|---|
| RSI | 60 (bullish) |
| MACD | Positive crossover |
| 50M EMA | ~$100 (support) |
| Price Zone | $120–$130 |
| Resistance | $160–$170 |
| Pattern | Ascending triangle |
🎯 Breakout Target: $200
📈 Long-Term Upside: $250–$300 (2028)
📊 9. Valuation & Analyst View
| Valuation Metric | Value |
|---|---|
| Market Cap | $3.04B |
| Trailing P/E | 89.09 |
| Forward P/E | 59.80 |
| Price-to-Book | 29.38 |
| Analyst Rating | Moderate Buy |
| Fair Value Gap | 45–52% upside |
❓ 10 Most Asked Questions About TMDX
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How does the OCS device work?
Preserves organs in near-living conditions using perfusion, improving success vs. cold storage. -
What’s fueling revenue growth?
Higher OCS usage, logistics revenue, and market share gains. -
Is TMDX profitable now?
Yes, first full-year profit in 2024, with strong Q1 2025 margins. -
What about the logistics side?
In-house aviation = faster, safer, cheaper transplants. $26.1M logistics revenue in Q1 2025 (+80% YoY) -
What’s the future TAM for TransMedics?
~$23B now; OCS Kidney can add another $5–7B. -
What happened with the FDA petition?
Cleared by independent review in 2024; no sanctions issued. -
Is the stock undervalued?
Yes. Current price is 45% below fair value. High upside potential. -
Why is volatility high?
High beta + medtech sector pressure; not due to fundamentals. -
Is expansion to Europe real?
Yes. Italy plant is operational. EU distribution expected in late 2025–2026. -
What’s the long-term price forecast?
If targets met, price could reach $250–$300 by 2028
✅ Final Investment Outlook
TransMedics is now a profitable, high-growth, vertically integrated medtech and logistics company with:
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📈 Rapidly growing revenue and earnings
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✈️ Aviation moat and transplant logistics
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💡 Product innovation + global expansion
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💵 Strong fundamentals and undervalued price
📌 Verdict: One of the most exciting mid-cap medtech stocks heading into 2025–2028.
