{ "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": 323, "pageCount": 342, "prevPage": 322, "nextPage": 324, "slideType": "preempt_rebuttal", "function": "preempt_rebuttal", "density": "dense", "nDataPoints": 0, "notes": "The slide uses a 'canary in the coal mine' metaphor to frame the loss of a major customer as a leading indicator of broader market share erosion.", "elementsJson": [ "paragraph", "callout_box" ], "metadataConfidence": 0.95, "imagePath": null, "slideHref": "/slides/019dd923-622c-750b-8b9a-40e2965928db/323", "deckHref": "/decks/019dd923-622c-750b-8b9a-40e2965928db", "deckJsonHref": "/decks/019dd923-622c-750b-8b9a-40e2965928db.json", "deckAnchorHref": "/decks/019dd923-622c-750b-8b9a-40e2965928db#slide-323", "components": [ { "bbox": null, "kind": "callout", "text": "NRP for DCS's...has the potential to really eat into the overall volume for TransMedics...personally, I feel quite confident that the outcomes are better with NRP than they are with OCS...NRP, I think, is better...and it’s obviously significantly cheaper.", "attrs": null, "subkind": null, "toolName": "Visual emphasis", "toolSlug": "visual-emphasis", "confidence": null, "componentId": "019dd953-5374-767b-b3bd-fb1c69d50fd5", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.25, "w": 0.86, "x": 0.07, "y": 0.45 }, "kind": "list", "text": "NRP taking off; outcomes are better; OPO's beginning to offer it\nQ: \"Where is that NRP trajectory in the liver community?\"\nA: \"It's a great question, at least when it comes to DCDs because really you only do NRP for DCDs, that has the potential to really eat into the overall volume for TransMedics. Personally, I feel quite confident that the outcomes are better with NRP than they are with OCS...NRP, I think, is better. And it's obviously significantly cheaper. That said, it does require more manpower of some form or another, whether it's on the OPO side or whether it's on the transplant center side, to do the NRP...and we are starting to see OPOs offer their own NRP services. Las Vegas, for example, the OPO in Las Vegas. The OPO in San Francisco, CADN. I know that the OPO in Los Angeles, which is one of the biggest in the country, is starting to roll that out as well. They're getting their own surgeons, so they're going to start offering it. Arizona is offering it as well.\" - Transplant surgeon at a high-volume West Coast academic center", "attrs": null, "subkind": "bullet", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "6da2f731-01d4-407b-9b0c-a2639dfe1c7f", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.22, "w": 0.86, "x": 0.07, "y": 0.72 }, "kind": "list", "text": "MGH interested in moving to NRP\nA: \"I mentioned other perfusion devices but NRP is an even more salient comparator here....our NRPs have been restricted to very local sites...we've done a handful; we've done a few NRPs.\"\nQ: \"Are you going to shift to NRP or are you kind of slower than some of these other centers?\"\nA: \"It's a great...I think there is a very strong case for changing our business model or changing our economic model to NRP...I think we're going to see NRP just gain in stature and in use, and I think you're going to start seeing real dents in the market share for TransMedics...they can't sustain that kind of cost model, and it really seems haughty...to even think they can get away with the kinds of additional charges that they're pinning on centers.\" - Transplant hepatologist Massachusetts General Hospital", "attrs": null, "subkind": "bullet", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "ba534923-8ccf-4cfe-9030-5fad21e43830", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.35, "w": 0.86, "x": 0.07, "y": 0.07 }, "kind": "paragraph", "text": "Some previously large users of TransMedics like Vanderbilt have already eliminated its use after moving to NRP. Other large customers indicated they are on the cusp of adopting NRP. One of TransMedics largest users, with 100 livers per year on OCS, stated NRP is better and cheaper – a canary in the coal mine: \"NRP for DCS's...has the potential to really eat into the overall volume for TransMedics...personally, I feel quite confident that the outcomes are better with NRP than they are with OCS...NRP, I think, is better...and it's obviously significantly cheaper...we are starting to see OPO's offer their own NRP services.\" Massachusetts General stated they've now wetted their beak: \"we've done a few NRP's...there is a very strong case for changing...our economic model to NRP...you're going to start seeing real dents in the market share for TransMedics.\"", "attrs": null, "subkind": "paragraph", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "671f6af5-f4a7-461e-9eb2-b38822b45baa", "frameworkName": null, "frameworkSlug": null }, { "bbox": null, "kind": "quote", "text": "“It’s a great question, at least when it comes to DCDs because really you only do NRP for DCDs, that has the potential to really eat into the overall volume for TransMedics. Personally, I feel quite confident that the outcomes are better with NRP than they are with OCS...NRP, I think, is better. And it’s obviously significantly cheaper.” — Transplant surgeon at a high-volume West Coast academic center", "attrs": null, "subkind": null, "toolName": "Authority citation", "toolSlug": "authority-citation", "confidence": null, "componentId": "019dd953-5374-767b-b3bd-fe367b50bb7d", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.03, "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": "6466198a-b780-44f0-b67a-04986662b4cf", "frameworkName": null, "frameworkSlug": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "imagePathAlt": null, "thumbSrc": null, "thumbSrcAlt": null, "locked": true }