{ "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": 296, "pageCount": 342, "prevPage": 295, "nextPage": 297, "slideType": "quote_slide", "function": "expose_contradiction", "density": "dense", "nDataPoints": 0, "notes": "The slide uses a direct quote from an expert to undermine the value proposition of the TransMedics device.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "metadataConfidence": 1, "imagePath": null, "slideHref": "/slides/019dd923-622c-750b-8b9a-40e2965928db/296", "deckHref": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckJsonHref": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json", "deckAnchorHref": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-296", "components": [ { "bbox": null, "kind": "callout", "text": "There’s no way to assess a heart on the device; NRP is only method", "attrs": null, "subkind": null, "toolName": "Visual emphasis", "toolSlug": "visual-emphasis", "confidence": null, "componentId": "019dd953-5374-767b-b3bc-b96d6172a0d3", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.55 }, "kind": "quote", "text": "At the end of the day, the device is a preservation machine. There are limitations in terms of the actual assessment of the heart on that device, that is not perfect. You watch it beat in the box. There are physiological reasons why it’s not the most robust test of organ quality and then lactate trends, not necessarily a marker that your organ is good or bad...there’s no way to assess it...the way your heart works and how we assess functionality is based on the ability to pump against resistance and load. And because you are in a solo, free-standing system with a TransMedics device, there is no resistance that it’s pumping against. If you resuscitate with NRP, which is normothermic regional perfusion, within the body of the donor, the resistance of that donor, blood vessels, etc., is put on the heart, and you can actually have a clear assessment of its functionality. That’s missing on the TransMedics’ device: true functional assessment of the organ. If it looks good on the machine, will it look good once you put it in and restart it and it’s not as strong?... There’s no alternative other than NRP, really.", "attrs": null, "subkind": "testimonial", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "a9d0a0b8-6f30-405b-a44a-1b55d4969494", "frameworkName": null, "frameworkSlug": null }, { "bbox": null, "kind": "quote", "text": "“At the end of the day, the device is a preservation machine. There are limitations in terms of the actual assessment of the heart on that device, that is not perfect. You watch it beat in the box. There are physiological reasons why it’s not the most robust test of organ quality and then lactate trends, not necessarily a marker that your organ is good or bad...there’s no way to assess it...the way your heart works and how we assess functionality is based on the ability to pump against resistance and load. And because you are in a solo, free-standing system with a TransMedics device, there is no resistance that it’s pumping against. If you resuscitate with NRP, which is normothermic regional perfusion, within the body of the donor, the resistance of that donor, blood vessels, etc., is put on the heart, and you can actually have a clear assessment of its functionality. That’s missing on the TransMedics’ device: true functional assessment of the organ. If it looks good on the machine, will it look good once you put it in and restart it and it’s not as strong?... There’s no alternative other than NRP, really.” — Transplant cardiologist at a major Ivy League academic center", "attrs": null, "subkind": null, "toolName": "Authority citation", "toolSlug": "authority-citation", "confidence": null, "componentId": "019dd953-5374-767b-b3bc-bf489d8a91d9", "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": "5ea5219b-c9f8-44ae-bcac-4a5c834971dd", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.03, "w": 0.45, "x": 0.07, "y": 0.51 }, "kind": "title", "text": "No way to assess a heart on the device; NRP is only method", "attrs": null, "subkind": "action-title", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "2a41bd29-652b-43b0-9ad4-7ff71b942901", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "title", "text": "A transplant cardiologist at a leading Ivy League center detailed the same concerns as Vanderbilt regarding an inability to properly assess a heart’s viability while on pump and its lack of predictive value – the entire point of the device, in contrast to NRP which he stated is the only way for a robust evaluation", "attrs": null, "subkind": "headline", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "a99105f1-d382-46b7-8fbb-235fccc8b01c", "frameworkName": null, "frameworkSlug": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "imagePathAlt": null, "thumbSrc": null, "thumbSrcAlt": null, "locked": true }