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  "documentTitle": "TransMedics (TMDX)",
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  "presentationDate": "2025-01-10 00:00:00",
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  "notes": "The slide uses a narrative structure to explain a systemic loophole, supported by a direct excerpt from an official policy document.",
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      "text": "Excerpt of policy change - criteria under which expedited organ offers can be made",
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      "text": "TransMedics and/or OPO's with whom it conspires allegedly start “dialing for dollars,” according to ex-employees and others, to offer the organ to centers willing to accept it with the understanding that it comes on a TransMedics pump and on its NOP aircraft.",
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      "text": "OPTN Notice of OPTN Policy Change Expedited Placement of Livers",
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      "text": "The full extent of the scheme became clear across interviews with ex-employees, transplant surgeons, and OPO’s: 1) TransMedics organ procurement team arrives for a retrieval; 2) the first center on the UNOS/OPTN transplant waiting list declines the organ, typically because it is old, defective, or otherwise compromised; 3) the organ is then classified as an “Expedited Offer,” a loophole in the OPTN organ allocation system which is now routinely abused to bypass the waiting list and preferentially steer the organ; 4) TransMedics and/or OPO’s with whom it conspires allegedly start “dialing for dollars,” according to ex-employees and others, to offer the organ to centers willing to accept it with the understanding that it comes on a TransMedics pump and on its NOP aircraft – unsurprisingly, its highest-volume and most corrupt customers seem to get the call. OPTN instituted expedited placement rules in March 2021, with criteria to prevent a “jump ball” when the first center declines an organ – a well-meaning rule that backfired by providing an official pretext for rampant abuses.",
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      "text": "Source: Scorpion Capital consultation calls with experts; https://optn.transplant.hrsa.gov/media/3451/expedited-placement-of-livers-policy-notice.pdf",
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      "text": "OPTN Notice of Policy Change for expedited organ offers, effective March 25, 2021",
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