{ "docId": "019dd923-622c-750b-8b9a-40e2965928db", "docSlug": "e5bffbaac707", "documentTitle": "TransMedics (TMDX)", "authorId": "58_Scorpion_Capital", "authorName": "Scorpion Capital", "documentKindSlug": "research-note", "documentKindLabel": "Research note", "sourceTypeSlug": "short_seller", "sourceTypeLabel": "Short seller", "presentationDate": "2025-01-10 00:00:00", "orientation": "landscape", "aspectRatio": 1.3333334, "pageNumber": 170, "pageCount": 342, "prevPage": 169, "nextPage": 171, "slideType": "expose_contradiction", "function": "expose_contradiction", "density": "dense", "nDataPoints": 4, "notes": "The slide uses a Q&A transcript format to build a case against the clinical justification of the product's usage.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "metadataConfidence": 1, "imagePath": null, "slideHref": "/slides/019dd923-622c-750b-8b9a-40e2965928db/170", "deckHref": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckJsonHref": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json", "deckAnchorHref": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-170", "components": [ { "bbox": null, "kind": "callout", "text": "Methodist is using TransMedics to \"basically make transplants a semi-elective operation\"; \"I frankly find that unjustifiable.\"", "attrs": null, "subkind": null, "toolName": "Visual emphasis", "toolSlug": "visual-emphasis", "confidence": null, "componentId": "019dd953-5373-719d-a97e-e83467f0a44c", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.55, "w": 0.86, "x": 0.07, "y": 0.35 }, "kind": "list", "text": "Methodist and Mayo use of TransMedics is for convenience and “really unjustified”\nQ: “So, you're saying most of the use now is livers where it doesn't need to be used?”\nA: “I know this because I talked to Mark Ghobrial about this. Seventy percent of their transplants use TransMedics. And when I asked him, I asked these are all DCD's? And he goes, no. He goes, in their program, only about 30% to 40% are DCD or older donors, so the rest of them are being used to basically make transplants a semi-elective operation. In other words, instead of operating at midnight or 1 or 2 in the morning operating all night long, they're using these devices to push the operation off until the morning. To me, that's a really unjustified use of resources to make the operation more convenient. It is really unjustified to use this technology to make life more convenient for the transplant team because I didn't train that way; I don't.”\nQ: “I've heard from calls that the main use case is that people don't want to operate at night. For the transplant center, it's just logistically easier to push it to the next day. They're leaving these livers on these pumps now for 10, 15, 20 hours, 30 hours sometimes.”\nA: “I agree with that. For me, I frankly find that unjustifiable. I can see once in a while, you've got a transplant scheduled, and then they call you up, and you have a great organ for another patient, but you only have one operating room.”\nQ: “If Ghobrial said 70% of their liver transplants use TransMedics, and for most of them, it's just because they pump it overnight because it's more convenient?”\nA: “Yes, that's what it sounds like to me. This is what our discussion was. They're doing it to make the operation semi-elective.”\nQ: “How many cases is Ghobrial doing as a high-volume user?”\nA: “I think they're doing 200 transplants a year. That's a lot. That's like 125, 150 - you do the math, but 70% of those use cases are for convenience.”\nQ: “Single-handedly alone, he's probably driving $15 million in revenue for the company.”\nA: “Oh yeah, possibly. Look at who the big users are. The same thing with Mayo. Mayo went from 100 transplants and they're doing 200-plus a year also.” –One of the top liver transplant surgeons in the world, based at a leading Midwest academic center", "attrs": null, "subkind": "bullet", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "23972368-295d-415f-a48d-403e0703425a", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "The information that Ghobrial at Houston Methodist allegedly shared with this surgeon is troubling – that ~70% of their TransMedics cases are simply “to push the operation off until the morning...it is really unjustified to use this...to make life more convenient for the transplant team.” We highlight that the surgeon who relayed this color is perhaps the world’s top liver transplant KOL, who stated that Methodist is using TransMedics to “basically make transplants a semi-elective operation”; “I frankly find that unjustifiable.” He estimated that Methodist and Mayo Arizona are using ~400 TransMedics pumps – a significant percentage of the company’s revenue particularly when NOP transport charges are included.", "attrs": null, "subkind": "paragraph", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "84488d2b-db18-4b2d-9c81-afdc128b1472", "frameworkName": null, "frameworkSlug": null }, { "bbox": null, "kind": "quote", "text": "“I know this because I talked to Mark Ghobrial about this. Seventy percent of their transplants use TransMedics. And when I asked him, I asked are these all DCD's? And he goes, no. He goes, in their program, only about 30% to 40% are DCD or older donors, so the rest of them are being used to basically make transplants a semi-elective operation.” — One of the top liver transplant surgeons in the world, based at a leading Midwest academic center", "attrs": null, "subkind": null, "toolName": "Authority citation", "toolSlug": "authority-citation", "confidence": null, "componentId": "019dd953-5373-719d-a97e-ecc301aa34e9", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.03, "w": 0.3, "x": 0.07, "y": 0.93 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "subkind": null, "toolName": null, "toolSlug": null, "confidence": null, "componentId": "8c63d5f2-0da6-4d98-85d8-2da40a4b13e7", "frameworkName": null, "frameworkSlug": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "imagePathAlt": null, "thumbSrc": null, "thumbSrcAlt": null, "locked": true }