TransMedics Group, Inc. Common Stock Canaccord Genuity's 46th Annual Growth Conference

Thank you, Bill. Good afternoon, everyone. Thank you for joining us. These are going to be a little bit more than a couple of slides because I felt it's important to cover a few important topics. This is our forward-looking statement. TransMedics is in the business of organ transplantation. Organ transplant is a very, very important therapy that happens to be the gold standard for treating a very, very expensive disease condition, and very chronic and very expensive disease condition. It's the gold standard for treating end-stage organ failure because it's the most cost-effective treatment. It's better than life on dialysis, it's better than LVADs, or even medical therapy. The problem with organ transplant, it's a supply-constrained market. There aren't enough organs to go to meet the huge demand for organ transplant on an annualized basis. TransMedics changed all that. TransMedics transformed the industry.

A few years back, we opened up the bottleneck for supply of organs by delivering on our technology or using our technology to deliver the highest rate of organ utilization in the history of organ transplant. Not only that, but we delivered the best clinical outcomes after organ transplantation. For the last four years, we've been building an entire network, vertically integrated network, to make more organ transplants and better organ transplants available across the U.S. So let me walk you through how we did it. We did it through a significant moat that is five layers deep. It starts with the first investing in its class technology called the Organ Care System, the only technology that replicated human physiology to keep organs alive and functioning outside of the human body. We did it with a portable technology.

Without it, we could not build the rest of the moat. We moved from there, and when we recognized the huge impact of the Organ Care System on increasing the supply of organs, we built a network called the National OCS Program, or NOP, which is the only national organ procurement service, door to door, from donor to recipient, to maximize organ utilization and provide the highest level of clinical standards for organ transplant. We didn't stop here. We built the first vertically integrated logistics, air and ground logistics that covers the entire U.S. To bring that to a bigger scale, we created a purpose-built digital ecosystem called NOP Connect that gives full visibility and transparency of all stakeholders in the field for what's happening with the organ, where is it located, secure communication.

As of July 1st, we added the last piece to the moat, which is donor and recipient screening. Every major transplant institution in this country cannot perform their daily transplant without communicating with TransMedics. Basically, TransMedics coordinating the donor and the recipient management within any major transplant institution. This is a very, very large and deep moat that is very difficult to replicate and costs a lot of money and a lot of time. Our financial performance is self-explanatory. We have been growing on an average of 86% CAGR over the last three years. We are profitable. We are generating free cash flow. We ended last quarter with more than $472 million in our balance sheet, and our revenue guidance for the year is between $737 million and $757 million, which represent 22% to 25% growth. Let me show you some of the evidence. This is our technology. This is the OCS platform, three FDA-approved technology, and the fourth organ, kidney, is under development, and we are bringing that to the clinic, hopefully second half of 2027.

This is what the National OCS Program or NOP looks like. Today, we are operating out of 20 different hubs across the U.S. We own and operate 100% dedicated 22 aircraft for organ transplant missions. We have approximately 50 procurement surgeons and staff between heart, lung, and liver, and kidney, and more than 250 clinical coordinators and specialists running an entire digital national command center out of our headquarters in Andover, Massachusetts. This is our digital platform, NOP Connect. You can see it is highly optimized to give full visibility across stakeholders. We are not stopping here. We are investing in four distinct growth initiatives to expand the growth even further and extend or expand our total addressable market.

There are four growth initiatives, starting with increasing heart and lung adoption. The OCS kidney program, which is going to be the biggest program ever developed by TransMedics, expanding internationally into Europe, bringing the NOP and the NOP success into Europe, and we are investing into scaling into the next gen OCS 3.0. Let me quickly touch on each one of these initiatives and why are they important for us to invest in today. First, U.S. heart and lung transplant, driving heart and lung transplant adoption, expanding our annual TAM in this critical segment of the market. What are we talking about? We are talking about having two shots a goal to access more than 5,200, 5,400 annual cases in the U.S.

5,400 hearts and lungs that today we do not have access to, and we are doing this using two shots a goal, OCS technology and CHOPS, which is a lower price point cold technology. Second is the kidney program. The kidney program is one of the most, if not the most, development program that I have ever been involved with, and I have been involved with all the programs involved with TransMedics. Why? Because it unlocks the largest transplant segment that has significant cost burden on CMS. Let us give you some numbers. Last year, there were approximately 21,000 deceased kidney transplant procedures in the U.S., but it does not stop here. We throw away nearly 10,000 kidneys because of extended preservation time. The OCS can change all that. So literally overnight with the kidney program, we can access close to 30,000 annual procedures that we do not access today.

But a lot of people in this room say, "Waleed, why are you investing in kidneys? The kidney is robust, and it's easy to put patient in dialysis." Well, it may be easy for you, but it's extremely difficult on the patient, and it's costing the system tens of billions of dollars. The cost of maintaining 100,000 patients on the national waiting list in the U.S. amounts to about $10.5 billion annually to CMS. After we transplant patients, 35%-50% of those patients require to go back on dialysis because of a complication of preservation called delayed graft function or DGF. That costs CMS an additional $150 million-$250 million annually.

So net-net, this is a huge opportunity in front of us to access 30,000 patients annually, and with a technology that is designed to significantly improve the utilization of donor kidneys to salvage more organs, save CMS billions of dollars of maintaining those patients on the waiting list, and significantly reducing the incidence of DGF, saving the CMS hundreds of millions of dollars annually. Next is the expansion into Europe. Why Europe? Why now? Why Europe? Because Europe is a mirror image of the United States from a market opportunity standpoint. The data is clear. Why now? Because we do not want to forget about Europe, the second-largest global transplant market, and two years from now, it's populated with much more inferior technology, and everyone asked, "Waleed, why didn't you go to Europe?" Most importantly, it's because of the patients.

The value that the OCS will bring to European patients, more organs and better outcomes. So Europe is a very important initiative. Finally, to scale all this, to be able to run tens of thousands of transplants on an annual basis across the globe, we need to invest in our technology platform. We're investing in our next-gen technology platform called OCS Gen 3.0, which is designed to be highly scalable, cloud-based control and monitoring, significant operating leverage, driving significant operating leverage. How? By completely redesigning the platform, lower part count, automated assembly to drive and to lower cost of goods, and de-risking the supply chain by being completely supply chain independent from critical suppliers. I'll leave you with this slide. TransMedics is uniquely positioned to capitalize on all these growth opportunities. We are confident based on our track record.

We have the best clinical device in the industry, generating the highest utilization rate and the best clinical outcome in the history of organ transplant, which is the OCS. We created a large moat of five layers deep that would take at least a decade and hundreds of millions of dollars to recreate. The growth runway is real. We have four shots a goal with one, the heart and lung has two shots each a goal with OCS and CHOPS. And finally, our track record speaks for itself. We are mission-driven, and we generated significant shareholder value based on investments we've made in the past. Thank you so much for your attention. And Bill, I'm looking forward to your questions.