Start here if you're new
what it is
TransMedics makes systems that keep donor organs working outside the body until transplant.
how it gets paid
Last year Transmedics made $605M in revenue. Heart transplant platform was the main engine at $235M, or 39% of sales.
why it's growing
Revenue grew 37.1% last year. The advance was probably driven by higher overall utilization of the company’s organ care system.
what just happened
TransMedics posted $445M in quarterly revenue, and sales jumped 209% vs. prior year.
At a glance
B+ balance sheet — decent shape, but not bulletproof
30/100 earnings predictability — expect surprises
52.6x trailing p/e — you're paying up for this one
16.0% return on capital — nothing to write home about
xvary composite: 51/100 — below average
What they do
TransMedics makes systems that keep donor organs working outside the body until transplant.
You are looking at the only FDA-approved organ-preservation platform for 3 transplant types in the U.S. That matters because the company still posted $605M in annual revenue, up 37.1%, with 60.6% gross margin. Leaving is painful when one system is already wired into the hospital workflow.
How they make money
$605M
annual revenue · their business grew +37.1% last year
Heart transplant platform
$235M
Lung transplant platform
$150M
Liver transplant platform
$120M
Logistics and service network
$100M
The products that matter
portable organ preservation platform
Organ Care System
$605M revenue · 100% of sales
it's the whole disclosed business today. The only FDA-approved portable system for preserving donor lungs, hearts, and livers generated all $605M of revenue.
100% of revenue
clinical utilization growth
Liver and Heart Adoption
+37.1% company growth
this is not a second product. It's the same OCS being used more often, especially in liver and heart programs, and that higher utilization drove the company's 37.1% growth.
growth engine
future expansion optionality
Next Applications
not part of current revenue
the optionality is real, but the current story is simpler. You are not buying a broad product portfolio yet. You are buying one platform with room to deepen its clinical footprint.
future upside
Key numbers
$3.20
fy2027 eps est
$1B
fy2029 rev est
52.6x
trailing p/e
60.6%
gross margin
Gross profit kept about 60.6% of each revenue dollar.
Financial health
B+
strength
- balance sheet grade B+ — solid but not elite
- risk rank 4 — safer than 20% of stocks
- price stability 5 / 100
- long-term debt $507M (10% of capital)
- net profit margin 18.4% — keeps 18 cents of every dollar in revenue
- return on equity 21% — $0.21 profit for every $1 investors have put in
B+ — functional but not a standout on the balance sheet.
Total return vs. market
You invested $10,000 in TMDX 3 years ago → it's now worth $21,070.
The index would have given you $14,770.
source: institutional data · total return
What just happened
beat estimates
TransMedics posted $445M in quarterly revenue, and sales jumped 209% vs. prior year.
Gross margin held at 60.6%. That is the kind of spread that says the operating model is still working hard.
$445M
revenue
$2.28
eps
60.6%
gross margin
the number that mattered
The quarter put $445M on the board, which is the kind of number that makes a 209% growth rate look real instead of promotional.
-
transmedics group likely closed out 2025 with good results.
-
we think fourth-quarter revenues soared more than 25% compared to the previous-year tally.the advance was probably driven by higher overall utilization of the company’s organ care system (ocs), particularly for the liver and heart. we believe december-quarter share earnings nearly doubled from a year ago, supported by the higher revenues, cost efficiencies, and elevated fleet utilization.
-
we look for another good year in 2026.
-
the top line will probably surge at a 20% rate due to expanding adoption of the ocs program.
-
we anticipate gains from all organs, with particularly robust growth from the liver market.
source: company earnings report
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What could go wrong
the main risk is ocs adoption slowing before the valuation does. This is not a diversified device company. It is one platform carrying a ~$5B stock story.
med
adoption slowdown
This is a growth stock with a medtech wrapper. If transplant centers slow their use of OCS in liver, heart, or lung programs, the market loses the volume story supporting 52.6x trailing earnings.
Why you should care: the average 2026 setup still assumes around 20% top-line growth. If growth falls short of that, the stock does not need bad news to get hit.
med
single-product concentration
100% of the company's $605M revenue comes from one platform. Any issue with manufacturing, safety, reimbursement, logistics, or clinical adoption runs straight through the entire income statement.
Why you should care: there is no second revenue engine today. Diversification is a future possibility, not a present fact.
med
valuation versus predictability
The stock trades at 52.6x trailing earnings, but earnings predictability is only 30/100 and price stability is 5/100. That's a premium multiple attached to a business that still surprises people.
Why you should care: even good quarters can produce a bad stock reaction if they land below expectations already pricing a very clean story.
One platform produced 100% of revenue, while the stock trades at 52.6x trailing earnings. That's a narrow operating base carrying a wide valuation expectation.
source: institutional data · regulatory filings · risk analysis
Pay attention to
metric
whether growth stays above 20%
That is the rough pace embedded in the 2026 setup. If revenue drops below that while the multiple stays rich, the valuation argument gets thinner fast.
trend
liver and heart utilization
Recent commentary keeps pointing back to liver and heart as the growth engine. You want more procedures, not just more awareness.
risk
single-platform exposure
As long as 100% of revenue comes from OCS, every operational issue becomes a company-wide issue. There is nowhere else for the business to hide.
calendar
next margin print
Last quarter's net margin was 16.9% versus 15.9% for the full year. If that keeps climbing, the scale story is real. If it stalls, one of the cleaner reasons to pay up disappears.
Analyst rankings
short-term outlook
average
momentum score 3 — in human-speak, the near-term setup does not show a clear edge.
risk profile
below average
stability score 4 — this stock swings more than most, which fits a company with 5 / 100 price stability.
chart momentum
top 20%
technical score 2 — in human-speak, the chart still looks stronger than most even if the fundamentals stay lumpy.
earnings predictability
30 / 100
low predictability means the business can beat hard or disappoint hard. That matters more when the multiple is already expensive.
source: institutional data
Institutional activity
institutions have been net buying for 3 consecutive quarters — 220 buyers vs. 171 sellers in 3q2025. total institutional holdings: 37.6M shares. net buying for 3 quarters.
source: institutional data
Price targets
3-5 year target range
$86
$255
$139
current price
$171
target midpoint · +23% from current · 3-5yr high: $245 (+75% · 15% ann'l return)
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