TransMedics Group, Inc. Q4 FY2025 earnings call

• 4Q 2025 was a banner quarter with 32% YOY revenue growth and 12% QOQ growth. U.S. transplant revenue up 11% QOQ, OUS up 33% QOQ. Operating profit $21.3 million, 13.2% of revenue. Full year 2025 total revenue $605.5 million, +37% YOY. Operating profit $108.6 million, 18% of revenue. - 4Q 2025 transplant logistics service revenue $28.6 million, +32% YOY, +5% QOQ. Maintained 80% coverage of NOP missions requiring air transport in 4Q. - 2025 saw growth in overall U.S. liver and heart and lung transplant volumes, OCS NOP cases driving this. - Focus on ENHANCE Heart program for heart transplantation, DENOVO Lung program for lung, bringing NOP model to Europe, OCS Kidney program on Gen 3.0 platform, and exploring U.S. transplant modernization initiatives

4Q 2025 total revenue was $160.8 million, +32% YOY, +12% QOQ. U.S. transplant revenue $155 million, +11% QOQ; OUS transplant revenue $5 million, +33% QOQ. Full year 2025 total revenue $605.5 million, +37% YOY. 4Q 2025 operating profit $21.3 million, 13.2% of total revenue. Full year 2025 operating profit $108.6 million, 18% of total revenue. 4Q 2025 transplant logistics service revenue $28.6 million, +32% YOY, +5% QOQ. OCS Liver transplants 2025: 4,197, 36% of overall liver transplant volume. OCS Heart transplants 2025: 854, ~18% of overall heart transplant volume. OCS Lung transplants 2025: 88, ~2% of overall lung transplant volume

Full year 2026 revenue guidance $727 million - $757 million, ~20% - 25% growth over 2025. Expect similar seasonal dynamics in U.S. transplant activities. Long-term gross margin expected around 60%. 2026 investment focus on R&D, NOP network, international expansion, systems optimization, infrastructure upgrades. Operating margins expected to be up to ~250 basis points below 2025 levels in 2026, then resume expansion towards 30% by 2028

• Building logistics infrastructure in Europe could moderate EU NOP launch pace. - Timing of DENOVO trial accrual depends on lung transplant market adoption of machine perfusion. - Timing of ENHANCE Part B completion influenced by competitive dynamics for cold storage arm. - Potential Q3 seasonality in U.S. transplant market temporarily slowing activities. - Ramping infrastructure and clinical staffing to meet growing demand for OCS NOP critical for 2026 growth

Q: Congrats on the good quarter, guidance on moving parts next year.

A: Took guidance seriously, factored in all dynamics, confident in guidance, execution will dictate if revisit.

Q: On OCS Liver registry publication, cost effectiveness data, competitive headwinds.

A: Health economic data on liver transplant already published, upcoming publications with statistical superiority, not seeing competitive headwinds impacting 2026 execution.

Q: Details on NOP Connect 2.0.

A: Vast majority of cases through it, seeing efficiency in management and billing, commitment to expand digital ecosystem.

Q: OCS Liver share gain in Q4, Part B of ENHANCE.

A: Liver share gain due to OCS Liver outcomes and execution, Part B will be executed despite competitive dynamic, confident in strategy.

Q: Heart trial feedback.

A: Trial early, good feedback, more meaningful presentations expected at ISHLT.

Q: CMS OPO changes.

A: Support CMS language and Wyden's bill, see role as win-win for TransMedics and OPOs.

Q: Operating margin guide 2026.

A: ~50% of incremental investment in 2026 from clinical programs completion, OCS Kidney development, OCS 3.0 development, transitory spend, confidence spend will normalize.

Q: Part B of ENHANCE trial competitive issue.

A: Competitor is static cold storage maker refusing to randomize, plan to bypass, transplant programs to take control.

Q: Heart and lung segments lower than expected.

A: Lung is rounding error, heart had some trial and organic activity dynamics, transient, ENHANCE and DENOVO expected to reverse dynamics