TransMedics Group, Inc. Common Stock 2026 Global Healthcare Conference

Great. Thank you, David, for the opportunity to be here today. Good morning, everyone. This is our forward-looking statement. TransMedics is in the very exciting field of organ transplantation. Organ transplant happens to be the gold standard of treating a very chronic and very expensive disease condition called end-stage organ failure. It's the gold standard of treatment because it provides patients with end-stage organ failure with the best quality of life and the longest life expectancy. It also happens to be the most cost-effective treatment for this very expensive disease condition. What is the problem in organ transplant? It's supply constraint. It's the availability of donors. It's our ability to utilize the available donor organs for transplantation. TransMedics transformed the field over the last several years. We increased the supply of organs by increasing the yield and utilization of donated organ to actual transplant and delivering superior clinical outcomes.

Let me walk you through our achievements to date and what excites us about the future and the future growth ahead of us. TransMedics approached this from a very different approach. We started as a medical technology company, but over the last four years, we built a very wide, deep, and large moat around that core business. First, we delivered the best technology for organ preservation by keeping organs in their normal physiologic functioning state outside of the human body, delivering superior clinical outcomes and the highest rate of organ utilization. Next, we built the only national end-to-end service model around the technology, called the National OCS Program, or NOP, that delivers clinical and surgical services for organ transplant cases across the country. Third, we added vertically integrated air and ground logistics network to make sure that every organ can be utilized for transplant can actually reach a potential recipient.

And fourth, we added a vertical or a broad digital ecosystem that can run the entire national transplant program indefinitely for the NOP and our network of utilizing centers. Finally, the last piece of the puzzle was adding a new service to truly become sticky with the organ transplant programs across the U.S., which is a donor and recipient screening service. So literally, simply stated, 2 years from now any transplant program across the United States will wake up in the morning and be connected to the OCS TransMedics digital ecosystem. They could run their entire transplant program through our network. And they could go to bed at night, the last thing they see is a TransMedics digital ecosystem giving them status of their organs that were offered and transplanted throughout the day.

We've proven over the last 4 years that we can not just only be a top-line grower, but a significantly profitable business. We've grown our revenue 86% over the last 4 years, generating significant operating leverage. We have a very healthy balance sheet, north of $470 million in the bank. And this year we're forecasting, or at least our guidance is contemplating 20%-25% year-over-year growth. This is our technology platform, three technology platforms that are already approved by FDA and one that we're very excited about coming, which is the OCS Kidney, and we'll talk about that shortly. The NOP network, again, is the only national network. We started with three hubs. Today we're operating out of 20 clinical hubs across the United States. That gives us access to the broadest number of donors across the country.

We have vertically integrated and own and operate 22 aircraft, 140 pilots, 50 procurement surgeons, 250 clinical specialists and coordinators across the country. This is our digital ecosystem, and as you can see, it's a broad platform that manages not just our NOP network, but also gives full visibility and transparency to the transplant programs across the country, as well as a massive digital command center that runs the entire national operations. Last year alone, we've done more than 35% of the national transplant volume were managed through the digital command center in the bottom left corner of the slide. But this is what we've achieved. As you know, this is a business of what have you done for me lately?

So we are very excited about the next gear of growth that, in our opinion, will be fueled by four massive engines of growth that we're very excited about and making some strategic investment in. First is expanding our heart and lung franchise in the U.S. Second, accessing the largest segment of organ transplant in the business, which is the kidney transplant market. Third is doubling the total addressable market by tackling the second-largest market of organ transplant in Europe. And finally, bringing in the next generation of the OCS technology platform that will generate significant leverage. So let's tackle each one of those and why we are making these strategic investment now and not waiting, and why we're excited about these opportunities. So first, expanding our heart and lung franchise.

Everybody knows that our liver franchise has grown exponentially, has been a major catalyst and engine and driver of our growth. We have two areas that we're very excited about, the heart and lung market. These are twin engines of our growth for 2027 and beyond. Let me give you a scale of what we're talking about. In heart, there's a segment of the heart market assessed at approximately 2,200 hearts that are DBD donors, less than four hours of preservation. We don't sell in that market today. We don't touch that segment of the market. This is a new clinical indication for us. In the lung, the entire market in the U.S. is about 3,200 lung transplants, and again, this is a very nascent market for us in the U.S.

We're going to tackle these two markets using both the OCS technology platform and a new technology that we built for cold, controlled hypothermic organ preservation system, or CHOPS, to access approximately 5,400 heart and lung a year, which dramatically expand our TAM in the U.S. from heart and lung market. We have four shots at goal with this program alone. Two shots with OCS, one in heart, one in lung, to access this significant opportunity, but also two shots with the second product, which is CHOPS, for any center that wants to segment the market based on a price point. That will be our portion as well. Second is the kidney market. This is one of the most exciting area that we're focusing on in TransMedics. It is the largest transplant segment that's conducted today. Let's talk about some important metrics.

People think, "Walid, why are you excited about kidney? Kidney is a very robust organ. There's no problems. It's very common to do kidney transplant." Well, there are significant problems in kidney transplantation, and we are going to fix that with the OCS and NOP. Let's start from the top. Every year, there's 21,000 deceased donor transplants in the U.S. You need to know that last year, we lost nearly 10,000 kidneys for one reason, and one reason alone, which is long time on ice. That's huge problem. Second, when you transplant a kidney today, you have a chance of 30%-55% that the kidney doesn't function well, adding significant cost. What are the costs we're talking about? CMS being the sole payer of end-stage renal disease in the United States. CMS covers the waiting list alone for more than $10 billion annually.

The cost of DGF costs CMS close to $250 million annually. What is the OCS going to do? OCS Kidney will give us direct access to nearly 30,000 kidney transplants in the United States coming from deceased donors, and OCS will deliver the highest rate of utilization and significantly reduce DGF, which means a significant cost efficiency to CMS. We could not be more excited about the kidney program, and we expect that to roll out the second half of 2027. Next is we're investing in replicating the success of the NOP in Europe. Why Europe? People are saying, "Walid, why are you focusing on Europe?" Well, Europe happens to be the second-largest international transplant market. We have an opportunity to nearly double the total addressable market. If you don't believe me, the numbers in Europe, as you can see here, is nearly equivalent to the United States.

In fact, they do more kidney transplant in Europe than in the U.S. So for us, this is a huge opportunity to double our addressable market and do it with a proven technology and a proven service model that we've successfully executed on in the United States. Finally, the OCS 3.0. That is a complete redesign and reimagination of the platform. Why? To scale. To be able to go from 5,000 transplants last year to 10,000 transplants in 2028 to 20,000 transplants in 2030, 30,000 transplants in 2032. What does 3.0 give us? Gives us significant leverage, both on the product and the service, and significant de-risking of the supply chain.

We could not be more excited about the significant operating product leverage that we gain with 3.0, and that should be the first leading edge of 3.0 is going to come with the kidney program second half of next year, and then we will go back and transform liver, heart, and lung in 2029 and 2030. To summarize, TransMedics is a very unique opportunity to transform not only organ transplantation, but also do that and deliver significant shareholder value. Why do we believe that? Well, we have the best technology with the best clinical evidence to support this technology. We build a very large, deep, and broad moat that is extremely difficult to replicate and extremely costly to replicate.