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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 direct quotes from a surgeon to undermine the company's value proposition.",
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      "kind": "callout",
      "text": "Radically cheaper to use cold storage for lungs",
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      "text": "“No one” using lung product anymore; total failure",
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      "text": "I do not see them having any market at all in lung anywhere in the United States or, for that matter, even worldwide compared to a much cheaper technology like 10-degrees Celsius storage.",
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      "text": "A prominent cardiothoracic transplant surgeon who leads a large academic program stated the lung product is as an utter failure as “no one’s using it anymore in the US”; that the “really enthusiastic centers that were heavily involved in the trials…have stopped using it”; that “I don’t see them having any future in lung”; and that a variety of cheaper alternative devices, already available or in trials, are not only superior but “just much, much cheaper.” He stated that extensive research and clinical trials since the OCS Lung approval have shown that cold storage around 10 degrees Celsius – slightly above traditional static cold storage – provides superior benefits over TransMedics warm perfusion pump, undermining the entire premise of its – “I do not see them having any market at all in lung anywhere in the US or, for that matter, even worldwide compared to a much cheaper technology like 10-degrees Celsius storage.”",
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      "text": "Q: “Does their device add anything in lung versus cold storage or other methods to justify the cost?” A: “The short answer is no. The longer answer is that despite that being the first approved device for TransMedics of an organ type, almost no one’s using it anymore in the US. It’s being used maybe 100-120 times per year, and most of the centers that I know, including the really enthusiastic centers that were heavily involved in the trials and the trial design, have stopped using it, and I don’t see them having any future in lung. And the reason for that is not just because of XVIVO’s collaboration with Lung Bioengineering, but more importantly, two years ago, the University of Toronto published their 10-degree Celsius storage story, and so there’s a spinoff company called Traferox that’s Canadian-based in conjunction with the University of Toronto that is currently doing a multi-center, large, randomized trial in the U.S. for transporting lungs at 10 degrees instead of a regular ice chest to give it a little bit like Paragonix. The short answer is to your question is that I do not see them having any market at all in lung anywhere in the United States or, for that matter, even worldwide compared to a much cheaper technology like 10-degrees Celsius storage.” – Prominent surgeon, director of leading academic transplant center",
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      "text": "“It’s just much cheaper. It’s much, much cheaper…the costs of the technology versus the reimbursement are so prohibitively expensive that if you can do something that only costs $5000 or $8000, which is probably where Traferox could come out, maybe even if you charged as much ridiculous charges as Paragonix does of $14,000 or $15,000 like they’re doing with their stupid device. The fact is it’s still much, much cheaper than $85,000, and the logistics are also more complicated. ” – Prominent surgeon, director of leading academic transplant center",
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      "text": "\"no one’s using it anymore in the US\"; \"really enthusiastic centers that were heavily involved in the trials...have stopped using it\"; \"I don’t see them having any future in lung\"; \"just much, much cheaper.\" — Prominent surgeon, director of leading academic transplant center",
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      "text": "Source: Scorpion Capital consultation calls with experts",
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