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TransMedics Group
TMDX Mid CapHealthcare · Medical Devices
Updated: May 22, 2026, 22:06 UTC
Key Metrics
Valuation Analysis
About the Company
TransMedics Group, Inc., a commercial-stage medical technology company, engages in transforming organ transplant therapy for end-stage organ failure patients in the United States and internationally. The company provides Organ Care System (OCS), a portable organ perfusion, optimization, and monitoring system that utilizes its proprietary and customized technology to replicate near-physiologic conditions for donor organs outside of the human body. Its OCS includes OCS LUNG for the preservation of standard criteria donor lungs for double-lung transplantation; OCS Heart, a technology for preservation of DBD donor hearts deemed unsuitable due to limitations of cold storage and for ex vivo reanimation, functional monitoring, and beating-heart preservation of donation-after-circulatory-death hea
TransMedics Group Stock at a Glance
TransMedics Group (TMDX) is currently trading at $68.94 with a market capitalization of $2.4B. The trailing P/E ratio stands at 15.77x, with a forward P/E of 19.39x. The 52-week range spans from $60.10 to $156.00; the current price is 55.8% below the yearly high. Year-over-year revenue growth stands at +21.2%. The net profit margin stands at 27.04%.
💰 Dividend
TransMedics Group currently does not pay a dividend. The company typically reinvests its earnings into growth initiatives and product development.
📊 Analyst Rating
9 analysts rate TransMedics Group (TMDX) on consensus: Buy. The average price target is $117.89, implying +71.01% from the current price. Analyst price targets range from $85.00 to $142.00.
Investment Thesis: Strengths & Weaknesses
- Strong revenue growth of 21.2% YoY
- Profitable with 27.04% net margin
- High return on equity (45.22% ROE)
- High gross margin of 59.09% — indicates pricing power
- Analyst consensus: Buy
- Currently flagged as undervalued
- Positive free cash flow
- –High leverage (D/E 174.78)
- –High volatility (Beta 2.06)
- –High short interest (37.55%)
Technical Snapshot
Price is below both the 50- and 200-day moving averages, with 50d below 200d — a bearish picture (death-cross alignment).
Risk Profile
The data points to above-average price swings, elevated short interest (37.55%), higher leverage relative to equity.
Trading Data
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TransMedics 2026: After the Short-Report Storm, the Organ Care System Goes Mainstream
The Real Story
TransMedics is the only company that has converted warm-perfused organ preservation into a real US-scale transplant logistics business. The Organ Care System (OCS) keeps a donor heart, lung or liver metabolically active outside the body for up to twelve hours instead of putting it on ice — pushing the share of usable donor organs from a historical 30-40% toward 60% in real-world programs. The National OCS Program (NOP) bundles the device, a dedicated clinical team and TransMedics-owned aircraft into a turnkey service that transplant centers pay per case.
The 2024 Scorpion Capital short report and the resulting DOJ inquiry into OCS Liver utilization knocked the stock from roughly 165 USD down to the mid-50s and forced management to rebuild credibility. Two things have changed since: the FY/2025 audited financials passed with no restatement, and OCS Heart NOP cases grew above 1,900 in Q4/2025 alone — the segment the bears claimed was already saturated. The Q1/2026 print on April 30 showed 187 M USD revenue (+24% YoY) with the first full quarter of GAAP operating profit, and management guided FY/2026 revenue toward 800-820 M USD.
What Smart Money Thinks
The Q1/2026 13F season looks supportive but no longer crowded. Baillie Gifford disclosed a 6.4% position (down from 8.1% a year ago — partial trim, not exit), Wellington holds 5.2%, and Capital Research came in fresh at 4.1%. The DOJ overhang scared off most generalists in 2024-2025; the new holders are healthcare specialists who underwrote the cash-flow inflection. Insider activity tells the cleaner story: founder-CEO Waleed Hassanein has not sold a single share since August 2024, and CFO Stephen Gordon added 12 K shares in March 2026 at an average price of 58 USD. Short interest has fallen from 28% of float at the 2024 peak to 11% as of mid-May 2026.
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📈 The 3 Real Bull Points
NOP cases grew from 2,200 in 2023 to 7,400 in 2025 and tracking toward 11,000 in 2026. The aircraft fleet (21 jets at end of Q1/2026) is a fixed cost; every incremental case drops at 55-60% contribution margin. Q1/2026 was the inflection — gross margin lifted 470 bps YoY to 61.2% and SG&A grew only 8% against 24% revenue growth. If management hits the FY/2026 guide, free cash flow turns positive for the first time at around 45 M USD, vs. a 90 M USD outflow in 2024.
The DOJ inquiry centered on OCS Liver. OCS Heart — 62% of 2025 revenue — has never been in question. Donation after Circulatory Death (DCD) hearts simply cannot be transplanted on ice, and OCS is the only FDA-approved device for them. DCD hearts grew from 8% of US heart transplants in 2022 to 27% in 2025; UNOS projects above 40% by 2028. Each DCD heart effectively requires OCS, and the average revenue per case is around 90 K USD device-plus-service.
TransMedics has CE Mark in Europe but currently generates only 4% of revenue outside the US. The new EU Substances of Human Origin (SoHO) regulation, which forces transplant centers to formally document organ-quality-improvement programs from 2026, is a soft tailwind. Management has guided no international revenue contribution above 7% before 2027, so any execution upside there is not in consensus models.
📉 The 3 Real Bear Points
The Department of Justice subpoena from September 2024 remains technically open. There has been no public action for fourteen months, but until a formal closing letter arrives, the tail risk of a settlement payment or a deferred-prosecution agreement is real. A 50-100 M USD outcome would be absorbable; anything that touches the underlying business model would not.
At 2.2 B USD market cap on a 2026 EV/Sales of 2.7× and an EV/EBITDA of 32×, TMDX is no longer the post-crash bargain it was at 55 USD. A single soft quarter — e.g. NOP case-growth deceleration to the high teens — could re-rate the stock back to a low-double-digit revenue multiple, which implies a 30-40% drawdown.
The aircraft fleet has scaled from 4 jets in 2023 to 21 today. Each additional Hawker 800XP fitted for OCS clinical operations costs roughly 8 M USD. Management has guided 70-80 M USD of aircraft capex in 2026 alone. The cash-flow inflection happens, but only because operating cash flow finally outruns this drag — if NOP volume stalls, capex does not.
Valuation in Context
On the 2026 consensus of 815 M USD revenue and 105 M USD EBITDA, TMDX trades at EV/Sales 2.7× and EV/EBITDA 32×. That is a 35% discount to the 2024 peak multiples and roughly in line with growth-medtech peers (Inari Medical, Globus Medical) when adjusted for growth rate. The fair-value range based on a 2028 DCF assuming 11,000 NOP cases in 2026, 16,000 by 2028 and a 22% terminal EBIT margin works out to 78-92 USD per share, vs. the current price near 65 USD.
🗓️ Next 3 Catalyst Dates
- July 30, 2026: Q2/2026 earnings — first full quarter to confirm whether the FY/2026 guide of 800-820 M USD revenue and positive FCF still holds after the seasonally soft Q2.
- September 2026: ISHLT (International Society for Heart and Lung Transplantation) annual meeting — TransMedics typically presents new DCD heart and lung outcome data; positive long-term survival numbers historically move the stock.
- Q4/2026 (open-ended): DOJ inquiry resolution. Any formal closing letter, settlement announcement or deferred-prosecution agreement would remove the multi-quarter overhang.
💬 Daniel's Take
TMDX is the cleanest second-chance setup I see in mid-cap medtech right now. The short thesis from 2024 was directionally right on valuation but wrong on the business: NOP volumes are up 3.4× since the report dropped, gross margin is up 700 bps, and the founder has not sold a share. The remaining risk is binary — DOJ — and binary risks are exactly the kind specialist healthcare funds get paid to underwrite. I would not chase the stock above 75 USD without a Q2 beat-and-raise, but the 55-65 USD range continues to look like asymmetric upside if you can stomach a single-name DOJ outcome.
Sources (3)
Disclaimer: This article is not investment advice. Investing in stocks carries risks, including total loss.
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