{ "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": 274, "pageCount": 342, "prevPage": 273, "nextPage": 275, "slideType": "expose_contradiction", "function": "expose_contradiction", "density": "overcrowded", "nDataPoints": 6, "notes": "The slide uses Q&A transcripts to highlight a shift away from OCS technology in high-volume transplant centers.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "metadataConfidence": 0.95, "imagePath": null, "slideHref": "/slides/019dd923-622c-750b-8b9a-40e2965928db/274", "deckHref": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckJsonHref": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json", "deckAnchorHref": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-274", "components": [ { "bbox": null, "kind": "callout", "text": "He stated their OCS usage fell from 60-70 cases from 2020 to 2023 to four cases in 2024, and that he sees the same trend at leading heart transplant programs around the country.", "attrs": null, "subkind": null, "toolName": "Visual emphasis", "toolSlug": "visual-emphasis", "confidence": null, "componentId": "019dd953-5373-719d-a988-81fe88cd6657", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.02, "w": 0.65, "x": 0.07, "y": 0.62 }, "kind": "list", "text": "Vanderbilt has ceased usage; high-volume users like UCSF are next with competition from NRP and coolers", "attrs": null, "subkind": "bullet", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "1bb1295a-ec68-42fc-aee6-58e972d217e2", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.02, "w": 0.35, "x": 0.07, "y": 0.33 }, "kind": "list", "text": "Vanderbilt heart usage of OCS has tanked", "attrs": null, "subkind": "bullet", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "73abefff-332a-464c-825f-7cd1da6383db", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.36 }, "kind": "paragraph", "text": "A: “Over the last four-ish years or so, we’ve done about 125 heart or multi-organ transplants, including heart per year. We’re shooting to around 140, I’m told, by the end of 2024. We perform the most heart transplants globally. Roughly, because I have the numbers in hand, between January 2020 and January 2023, and this is publicly available from data we’ve published [...] the use of OCS was roughly about a third of those hearts. 21 out of 122—that’s like 1/6 of the DCD hearts during that three-year time frame used OCS. Out of 120 cases and that was just for DCD. We used it probably another 30 or 40 times amongst another 260 brain-dead hearts during that same time frame. So, probably brings our total OCS volume between 2020 and 2023 to roughly about 60-70 or so.” Q: “How is that trending?” A: “The trend has been going down. For example, thus far this year, we’ve used it four times. Last year, OCS overall for the entirety of January to December 2023, we used it a total of 12 times over all DCD cases.”-Transplant cardiologist at Vanderbilt", "attrs": null, "subkind": "paragraph", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "8100b9bf-177a-4133-a85a-66572d72b872", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.65 }, "kind": "paragraph", "text": "Q: “Are there programs that you know of where the utilization of OCS has just really gone down dramatically? They stopped using it completely, like high-volume ones?” A: “That was essentially us. Three years ago, I thought we were going to be using it a lot more and it dropped down into the low single digits in this time span. The more we talked to other high volume centers like UCSF, etc., there’s just lots and lots of utilization of it. We’ve all gotten good at NRP. We all have large surgical teams to send our surgeons and perfusionists to procure organs via NRP, and we’re involved in all these different cooler trials regardless of what cooler it may be, and we’re getting the same distance benefits from those coolers as well. But it really cuts down the need for OCS in terms of what situations are we really using it for. We’re not using them for marginal hearts anymore, really. We’re not really using them for distance. It really comes down to what are those few scenarios per year where we generally don’t have the surgical bandwidth when we have a potential offer for one of our listed patients.” -Transplant cardiologist at Vanderbilt", "attrs": null, "subkind": "paragraph", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "be63e678-25fb-4dd5-b33f-dfd1cb08d5de", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "A second Vanderbilt source – a transplant cardiologist – echoed the color from his liver transplant colleague for heart/lung, stating that they are the highest volume transplant program in the world. He stated their OCS usage fell from 60-70 cases from 2020 to 2023 to four cases in 2024, and that he sees the same trend at leading heart transplant programs around the country, due to the superiority of NRP and the fact that newer coolers provide the same benefits at a fraction of the cost: “the trend has been going down...three years ago I thought we were going to be using it a lot more and it dropped into the low single digits in this timespan...we’re involved in all these different cooler trials...and we’re getting the same distance benefits from those coolers as well.”", "attrs": null, "subkind": "paragraph", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "cf708d13-5dc5-4c1a-953b-0d9800a23eba", "frameworkName": null, "frameworkSlug": null }, { "bbox": null, "kind": "quote", "text": "the trend has been going down...three years ago I thought we were going to be using it a lot more and it dropped into the low single digits in this timespan...we're involved in all these different cooler trials...and we're getting the same distance benefits from those coolers as well. — Transplant cardiologist at Vanderbilt", "attrs": null, "subkind": null, "toolName": "Authority citation", "toolSlug": "authority-citation", "confidence": null, "componentId": "019dd953-5373-719d-a988-85008653c6ee", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.02, "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": "8d1b4213-10c8-43ae-b423-564d99281b47", "frameworkName": null, "frameworkSlug": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "imagePathAlt": null, "thumbSrc": null, "thumbSrcAlt": null, "locked": true }