FestivusCap
Public Equities Commentary
TransMedics' 10,000-case volume target looks out of reach for its core business because liver volumes are close to hitting a wall. Hitting it would likely mean counting CHOPS cases, which another poster estimates bring about $5k of product revenue each versus over $100k for OCS cases, and the market won't put a multiple on that business. CHOPS likely was not contemplated when the target was set three years ago, and it carries cannibalization risk. x.com x.com x.com x.com
TransMedics now looks weak, and weak names are not worth touching regardless of how cheap they look. The market is selling on falling operating margins; rising costs come from R&D and clinical trials, which is healthy, but there is more to it than margins. TransMedics is not passing fuel costs fully to customers, covering only part with a flat fee, and it is now offering cold-storage transplants, shifting from running both trial arms itself to offering the service. x.com x.com x.com x.com x.com
TransMedics' capital allocation adds risk, turning the stock into a show-me story despite results that mathlonning's recap calls solid. Its non-core charter business in Europe brings incrementally more execution risk and margin dilution, and it is questionable whether the company keeps pricing power as oil drops. Spending $12m on consultants is not a great look either. x.com
TransMedics could gain from OPO openings if the Kidney Care National Plan displaces poorly performing operators. Per @ZackStacksKap, the plan calls for stricter standards, decertifying failing OPOs and faster certification of new competitors. Becoming an OPO would be particularly bullish; CEO Waleed Hassanein has put the chance at 50/50 and excludes it from guidance and case targets through 2032. x.com x.com
TransMedics' investment case is broken because operating margins are tracking near 11% instead of the expected path above 21%, and management is signaling further near-term pressure as investment continues. That gap is too large to stay invested. x.com
TransMedics' best trade is likely over: in biotech, by the time competition starts being discussed, most of the gain has been made. Another investor notes its technology is great but very expensive, with many working to replace it. x.com
TransMedics is cheap here, with solid flight activity and margin compression set to turn around, leaving little to worry about for longs. x.com
TransMedics still looks undervalued even at $94 after a strong Q2 earnings report, which puts it back on the buy list. The company has quietly been crushing it. x.com
TransMedics' long-term story stands despite a roughly 60% stock drop, because its organ transplant model is hard to replicate. It sells the machines and also handles retrieval and transport with its own aviation fleet and clinical teams. Margins are compressed by deliberate heavy investment, alongside regulatory issues and a lingering short report. About three-quarters of the TAM remains in the US, Europe is opening through Italy and PAD Aviation, and kidney transplants could double the TAM. … Show more
TransMedics' long-term case is not threatened by high oil prices or Chinese regeneration drugs. It partly passed logistics costs on to hospitals last quarter, and the regeneration therapies @chillthehate cites look like a risk perhaps a decade out. @Stavanger68's FY29 assumptions of about $1.67B revenue and $9.5 EPS are aggressive but broadly aligned. Kidney could drive FY28-29 growth, though med-device launches usually take years to gain traction. x.com x.com x.com x.com
TransMedics is due for a re-rating as it becomes a fully integrated logistics network for organ transplants, not just a device maker. Its 22 aircraft flew nearly 9,000 missions last year, supporting about 26% of US transplants. It targets 10,000 US cases by 2028 and 30,000 globally by 2032, helped by a kidney platform, and projects revenue rising from $605 million to $2.5-3 billion in four to five years. It is high risk, high reward, with a possible 100%+ rebound in two to three months. x.com … Show more