{ "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": 186, "pageCount": 342, "prevPage": 185, "nextPage": 187, "slideType": "expose_contradiction", "function": "expose_contradiction", "density": "dense", "nDataPoints": 4, "notes": "The slide uses expert testimony to challenge the value proposition of the TransMedics technology.", "elementsJson": [ "paragraph", "quote_block" ], "metadataConfidence": 0.95, "imagePath": null, "slideHref": "/slides/019dd923-622c-750b-8b9a-40e2965928db/186", "deckHref": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckJsonHref": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json", "deckAnchorHref": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-186", "components": [ { "bbox": null, "kind": "callout", "text": "While TransMedics claims that its pump has grown transplant volumes by making DCD organs usable, the claim is false: DCD's have spiked because OPO's and transplant centers are under pressure to show volume for compliance reasons.", "attrs": null, "subkind": null, "toolName": "Visual emphasis", "toolSlug": "visual-emphasis", "confidence": null, "componentId": "019dd953-5373-719d-a97f-f0973334f87b", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.45, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "The bull case for TransMedics is that a normothermic pump purportedly enables the use of DCD organs, which are of dubious quality and therefore unused prior to the pump – “historically, DCD livers were utilized, in a gray area, maybe 8% of the time...so very, very low utilization.” While TransMedics claims that its pump has grown transplant volumes by making DCD organs usable, the claim is false: DCD’s have spiked because OPO’s and transplant centers are under pressure to show volume for compliance reasons, with the prospect of smaller OPO’s and centers being shut down or losing their certification – and they have resorted to using organs they would never touch before, not because a pump magically heals them, but because it gives them a pretense. We quote a high volume user: “that’s where and why we started to use because there’s a lot of pressure to transplant our patients...our cut-off was like 30 years old...now we’re going up to 60-65...so it’s increased that dramatically.”", "attrs": null, "subkind": "paragraph", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "8c594428-3ba2-45c7-a4ee-8b8ab50cd440", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.78 }, "kind": "quote", "text": "Using for 60-65 year-old donors when cut-off was 30, or 40 “if pristine”. “The donors are older because we weren’t accepting DCD livers that were - I think our cut-off was like 30 years old, maybe we considered 40 if they were pristine and, say, a gunshot wound to the head. Now, we’re going up to 60-65. So, it’s increased that dramatically.” – Transplant surgeon and surgical director in Utah", "attrs": null, "subkind": "testimonial", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "6fc5e6bb-15ab-4211-8fc4-ffcb98a16a79", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.2, "w": 0.86, "x": 0.07, "y": 0.55 }, "kind": "quote", "text": "TransMedics usage due to pressure on OPO's to grow using questionable “gray area” DCD organs. “There’s been a mandate that an OPO’s DCD volume should be between 45% and 50% of total organ donors. Historically, DCD livers were utilized, in a gray area, maybe 8% of the time. So, very, very low utilization. And so, how do you grow? If the OPO is going to continue to increase DCD but you can’t really grow 80% but what the TransMedics does it allows you to use those organs; it resuscitates them. That’s where and why we started to use them because there’s a lot of pressure to transplant our patients.” – Transplant surgeon and surgical director at a high volume academic center in Utah", "attrs": null, "subkind": "testimonial", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "bf1b161d-2d51-4857-b1b0-3bcf9a44fa8c", "frameworkName": null, "frameworkSlug": null }, { "bbox": null, "kind": "quote", "text": "“historically, DCD livers were utilized, in a gray area, maybe 8% of the time...so very, very low utilization.” — Transplant surgeon and surgical director at a high volume academic center in Utah", "attrs": null, "subkind": null, "toolName": "Authority citation", "toolSlug": "authority-citation", "confidence": null, "componentId": "019dd953-5373-719d-a97f-f79a779986df", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.03, "w": 0.3, "x": 0.07, "y": 0.95 }, "kind": "source-note", "text": "Source: Scorpion Capital consultation calls with experts", "attrs": null, "subkind": null, "toolName": null, "toolSlug": null, "confidence": null, "componentId": "6bd1339f-c26a-41a6-b3fa-b6530a5a0d02", "frameworkName": null, "frameworkSlug": null } ], "metrics": [], "tools": [], "frameworks": [ { "name": "ceo-quote-contradiction", "slug": null, "matchId": "e27038d7-e6e8-4b05-94cf-6c9808f4e2fc", "evidence": "The slide explicitly contrasts the company's 'bull case' claim with expert testimony that contradicts the underlying mechanism.", "confidence": 0.9 } ], "arcBeats": [], "loops": [], "imagePathAlt": null, "thumbSrc": null, "thumbSrcAlt": null, "locked": true }