TransMedics Group Inc

TransMedics makes the Organ Care System, or OCS, a portable machine that keeps donated hearts, lungs and livers warm and working outside the body on the way to a patient. It pumps warm, oxygen-rich blood through the organ, so the heart beats and the lung breathes, and doctors can check and improve the organ before surgery. The standard alternative, cold storage, means packing the organ on ice in a cooler, which injures it over time. All three OCS products have FDA premarket approval, the agency's strictest review for medical devices.

Its customers are transplant centers. Through its National OCS Program (NOP), TransMedics also provides US transplant programs with surgeons to retrieve organs, specialists to run the machine, and air and ground transport, including 22 aircraft it owns. It added its own flights by acquiring charter operator Summit Aviation in August 2023. Hospitals bill Medicare and private insurers for these costs through standard transplant billing.

Much of the revenue repeats, because every OCS transplant needs a new single-use, organ-specific disposable set. In fiscal 2025, revenue reached $605.5 million, up 37.1% from the year before. Product sales made up 61.5% and services 38.5%. As of December 31, 2025, most of its 898 employees worked in the US, and the company also had operations in Europe.

• In Q2 FY2026 (ended Jun 30, 2026), revenue was $189.9M, up 20.7% from a year earlier, and net income was $14.7M (-57.9%).
• For fiscal 2025, revenue was $605.5M (+37.1% year over year; +88.2% a year from FY2020 to FY2025) with a 31.4% net margin.

• Over FY2021–FY2025: $0.00 in buybacks and $0.00 in dividends.
• The company pays no regular dividend.
• Shares outstanding changed +25.3% from Jul 31, 2021 to Jul 30, 2026.

Rank among 1514 US companies

Market value at each year end

TransMedics Group’s market value went from $402.3M at the end of 2019 to $2.32B on Oct 28, 2026, about 5.8 times as much; since the end of 2025 it is down 44%.

Form 4 filings from 2025-10-31 to 2026-10-31 (25 read): 2 open-market purchases ($1.1M) and 11 sales ($4.3M).

Large shareholders (13G filings)

ETFs with the most weight in TMDX

1. Growth rests on one product platform. TransMedics depends heavily on the OCS winning wider use over cold storage. Long-term growth also hinges on expanding the National OCS Program and launching next-generation products, which may not succeed.
2. A device maker flying its own planes. TransMedics has limited experience operating aircraft. A poor safety record, pilot shortages, fuel prices, rising maintenance costs and reliance on one aircraft maker could raise costs or damage trust with transplant centers.
3. Few customers and unpredictable organ supply. A limited number of transplant centers provide a significant portion of revenue. Revenue also swings from quarter to quarter with the unpredictable supply of donor organs and available surgeons.
4. Insurance coverage is not guaranteed. Transplant centers rely on Medicare and private insurers to cover OCS and NOP costs; weaker coverage could cut demand. Outside the US, long-term reimbursement must be won country by country, sometimes with extra clinical studies.
5. Supplier, recall and approval problems. Many OCS parts come from a single supplier, and a few have no alternative supplier at all. The products have faced recalls before, and losing FDA approval or European marks would stop sales there.
6. Significant debt to repay. Debt totaled $474.3 million as of June 30, 2026, against $491.1 million of cash and investments. It includes convertible notes due 2028, bonds that can convert into shares, and repaying them takes significant cash.

• Sep 10, 2026 Executive or board change; Investor presentation or announcement
• Aug 4, 2026 Quarterly results released
• May 21, 2026 Shareholder vote results
• May 5, 2026 Quarterly results released
• Feb 27, 2026 Quarterly results released
• Feb 4, 2026 Executive or board change
• Jan 12, 2026 Major agreement signed; Other company announcement

TransMedics paid no dividend in any fiscal year from 2020 to 2025 and spent nothing on share buybacks from fiscal 2021 to 2025. Instead, its share count rose 25.3% between July 2021 and July 2026, which spreads ownership more thinly. For an income investor, that means no cash payouts. Any return comes only from the share price, and turning it into spending money means parting with shares.

The price has swung sharply. In the 2020 COVID crash, the stock fell 47.7% and took about 10 months to recover. In the 2022 bear market it dropped 38.2% early on but recovered within a month, and it ended the market's full downturn up 104.1%. As of October 28, 2026, the shares were down 48.4% over one year, and their worst drop over three years reached 67.8%. As a single stock, TransMedics carries more risk than a diversified fund.