{ "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": 308, "pageCount": 342, "prevPage": 307, "nextPage": 309, "slideType": "villain_critique", "function": "name_villain", "density": "overcrowded", "nDataPoints": 1, "notes": "The slide uses expert testimony to undermine the value proposition of TransMedics' portability.", "elementsJson": [ "paragraph", "quote_block", "footnote" ], "metadataConfidence": 0.95, "imagePath": null, "slideHref": "/slides/019dd923-622c-750b-8b9a-40e2965928db/308", "deckHref": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckJsonHref": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json", "deckAnchorHref": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-308", "components": [ { "bbox": { "h": 0.03, "w": 0.86, "x": 0.07, "y": 0.66 }, "kind": "callout", "text": "United Therapeutics’ Lung Bio-Engineering has already rigged 600 lungs at perfusion centers", "attrs": null, "subkind": "primary", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "31ab6cf9-2ed2-489e-94cd-f4964b867ffb", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.03, "w": 0.86, "x": 0.07, "y": 0.45 }, "kind": "callout", "text": "Back to base is superior, cheaper, no benefit to fully transportable perfusion pump", "attrs": null, "subkind": "primary", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "ffa0abe7-f675-4392-b484-eb57b728becb", "frameworkName": null, "frameworkSlug": null }, { "bbox": null, "kind": "callout", "text": "TransMedics portability is irrelevant, as its primary use case is not clinical but scheduling and convenience - in other words, it is already mostly used off-label as a back-to-base device while OR’s wait for surgeons to wake up or stack cases.", "attrs": null, "subkind": null, "toolName": "Visual emphasis", "toolSlug": "visual-emphasis", "confidence": null, "componentId": "019dd953-5374-767b-b3bc-25c0055f0447", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "Some of the newer systems are “back-to-base” which poses a particular threat to TransMedics, which is portable – “the data is not quite there to prove that a fully transportable device is superior, and logistically it’s easier and cheaper to Vita Smart rig the device after it’s been transported.” Non-portable pumps - located at hospitals, local OPO’s, or United Therapeutics dedicated perfusion centers – are less expensive and also provide more organ assessment and therapeutic capabilities, having no size constraints. TransMedics portability is irrelevant, as its primary use case is not clinical but scheduling and convenience – in other words, it is already mostly used off-label as a back-to-base device while OR’s wait for surgeons to wake up or stack cases. Moreover, our research indicated that a rapidly increasing use case is transporting organs to the center on ice and then putting them on TransMedics - precisely back-to-base usage.", "attrs": null, "subkind": "paragraph", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "01ab3314-bb73-4f30-b8b3-800176efc123", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.15, "w": 0.86, "x": 0.07, "y": 0.48 }, "kind": "quote", "text": "“Simultaneously and, in fact, ahead of TransMedics, XVIVO was working on this. They had a different concept. Instead of doing the fully transportable system that TransMedics has, their concept is what’s called “back to base.” And there are several companies are out there that are like that, including VitaSmart who along with XVIVO feel that the data is not actually quite there to prove that that a fully transportable device is actually superior, and logistically, it’s easier and could potentially be cheaper to rig the device after it’s been transported to the transplant center or to the OPO.” – Prominent surgeon, Director of leading West Coast academic transplant center", "attrs": null, "subkind": "testimonial", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "9348407f-d0b1-4420-8be2-31a1831cb76b", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.23, "w": 0.86, "x": 0.07, "y": 0.69 }, "kind": "quote", "text": "“Lung Bio-Engineering and United Therapeutics have a completely different business model, which is they have their recovery centers, one in Silver Springs, Maryland and the other in Jacksonville, Florida, associated with Mayo. They are rigging lungs, and they’re eventually going to do livers. [They] can physiologically evaluate a lot more than what TransMedics can do because they’re in a facility; they’re not just on a little portable machine. And if the organs are considered acceptable, in the case of lung, based on oxygenation, lung compliance, and pulmonary pressures, then the organ is flushed cold again and then transported to the transplant center. Just to give you an example that TransMedics is not alone in this enterprise, there have been over 600 lungs that have been rigged by the lung bioengineering folks in Maryland that have been transplanted from Toronto down to Duke all the way to Cleveland, New York at Columbia Presbyterian. So, this is not some Star Wars concept; this is something that’s practically going on, and they, in fact, are going to go for FDA approval third quarter of this year, is my understanding from what they’ve said at the meeting.” – Prominent surgeon, Director of leading West Coast academic transplant center", "attrs": null, "subkind": "testimonial", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "9ad08569-520c-4372-b159-4cc94308bd75", "frameworkName": null, "frameworkSlug": null }, { "bbox": null, "kind": "quote", "text": "“Simultaneously and, in fact, ahead of TransMedics, XVIVO was working on this. They had a different concept. Instead of doing the fully transportable system that TransMedics has, their concept is what’s called “back to base.” And there are several companies are out there that are like that, including VitaSmart who along with XVIVO feel that the data is not actually quite there to prove that a fully transportable device is actually superior, and logistically, it’s easier and could potentially be cheaper to rig the device after it’s been transported to the transplant center or to the OPO.” — Prominent surgeon, Director of leading West Coast academic transplant center", "attrs": null, "subkind": null, "toolName": "Authority citation", "toolSlug": "authority-citation", "confidence": null, "componentId": "019dd953-5374-767b-b3bc-287dbe52f92e", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.02, "w": 0.25, "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": "09ba47b7-5f3f-4a4b-8440-5a8bbb7ab9b8", "frameworkName": null, "frameworkSlug": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "imagePathAlt": null, "thumbSrc": null, "thumbSrcAlt": null, "locked": true }