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' 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' 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' 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' latest CFO change is another red flag for a sketchy company. CEO Waleed Hassanein is hard to work with and hires yes-men who aren't any good, which helps explain the revolving door in the CFO role. x.com  x.com  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 

The valuation gap between Strata Critical Medical and TransMedics should close as Strata scales profitably while TransMedics burns cash. Strata's margins improve with scale, and its kidney logistics market is largely untapped, so new competitors would face its first-mover advantage. TransMedics has the stronger technical moat and may build superior warm-perfusion kidney devices, but trials are a science project until they deliver profits. Both could succeed, and might even cooperate. x.com  x.com  … Show more

Strata Critical Medical is a reclassification story, having turned from Blade's helicopters and eVTOL optionality into a pure-play organ transplant logistics and clinical services platform. Everyone knows the TransMedics story, but Strata is the more interesting setup from here. x.com 

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 

Boston Scientific and Abbott are cheaper than their history but unlikely to compound at 20% over the next five years. The medical-device selloff looks like a clear overreaction, but Intuitive Surgical is worth paying up for even after a 30% drawdown, and TransMedics and PROCEPT BioRobotics have a real shot at about 30% annual returns over five years on 20%-plus revenue growth, operating leverage and possible multiple expansion. Favoring growth over cheaper names means more risk but more upside. … Show more