We continue to believe that this TransMedics platform can support approximately 30,000 transplants by 2032, deriving more than $2 billion in top-line annual revenue with a healthy operating profile. Our capital allocation priority has always been, and it is unchanged and deliberate. We are focused on durable top-line growth ahead of near-term operating leverage. Turning to the quarter, second quarter 2026 with the strongest in our history in both revenue and case volume.
Total revenue of approximately $190 million, up approximately 21% year-over-year and approximately 9% sequentially. Transplant product revenue of $111 million, up approximately 16% year-over-year and approximately 3% sequentially. Service revenue of $79 million, up approximately 29% year-over-year and approximately 19% sequentially. Growth was led by liver, which was up approximately 28% year-over-year and approximately 7% sequentially.
Heart also grew approximately 6% year-over-year and approximately 23% sequentially, and we expect heart to continue to accelerate in the fourth quarter and beyond as we unlock ENHANCE Heart Part B. This growth is the clearest evidence yet that vertical integration of logistics is both a growth engine and a structural differentiator for TransMedics. Adjusted income from operation of approximately $25.8 million, or approximately 14% of revenue, delivered while continuing to fund our growth initiatives. We ended the quarter with approximately $473 million in cash and cash equivalent, giving us great confidence in our ability to self-fund our growth investment from the balance sheet and operations.
| Metric | Period | Current guidance |
|---|---|---|
| Full-year 2026 revenue (ex-PAD) | FY2026 | $737M-$757M (~22-25% growth); assumes no ENHANCE Part B / DENOVO contribution |
| Full-year adjusted operating margin (ex-PAD) | FY2026 | ~12.5%-14% (reduction reflects higher OCS Kidney investment) |
| Second-half gross margin (ex-PAD) | 2H 2026 | ~59% (service margin normalizing but above historical levels) |
| Long-term gross margin | next 2-3 years | broadly around current levels, trending toward ~60%+ as OCS Kidney/Gen 3.0 scale |
| Full-year interest expense | FY2026 | ~$29M (incl. ~$15.3M HQ-related), partially offset by ~$12M interest income |
| Full-year effective tax rate | FY2026 | ~26% |
| PAD Aviation contribution | FY2026 | not yet quantified; dilutive near-term; guidance to be provided in Q3 |
| Metric | YoY | Note |
|---|---|---|
| Total revenue | +21% to ~$190M (+9% QoQ) | Record OCS case volume plus strong clinical and logistics services growth. |
| Transplant product revenue | +16% to ~$111M (+3% QoQ) | Led by liver. |
| Service revenue | +29% to ~$79M (+19% QoQ) | Broader TransMedics Logistics adoption, market-share gains and pricing adjustments to offset higher fuel cost. |
| Liver revenue | +28% (+7% QoQ) | Continued strong OCS liver adoption; ~$148M in the U.S. |
| Heart revenue | +6% (+23% QoQ) | ~$33M in the U.S., expected to accelerate in Q4 as ENHANCE Heart Part B unlocks. |
| TransMedics Logistics revenue | +39% to ~$41M (+30% QoQ) | Market-share gains (including a competitor's lost major account) plus efficiency. |
| Total gross margin | 59.6% (+140 bps QoQ, -180 bps YoY) | Sequential gain from service margin (27%->35%); YoY decline from service mix and temporary product-cost pressures. |
| Adjusted operating margin | 13.6% | Planned increase in strategic investment plus gross-margin factors. |
| Adjusted diluted EPS | $0.44 | Adjusted net income of $16.2M on ~40.7M diluted shares. |
| Topic | Previous mention | Current period | Trend |
|---|---|---|---|
| Growth-over-leverage capital allocation | Prioritize durable top-line growth | Unchanged and deliberate: funding OCS Kidney, next-gen OCS Gen 3.0, ENHANCE/DENOVO and international expansion over near-term operating leverage; investors weighing this against margins amid stock volatility, which management addressed directly with data. | — |
| OCS Kidney program | — | Framed as the single largest addressable segment (21,000+ U.S. deceased kidney transplants/year, ~9,200 recovered-but-not-transplanted, ~$10B CMS waiting-list cost); first portable normothermic oxygenated kidney perfusion system on Gen 3.0; first pre-IDE FDA meeting held, first clinical experience targeted late 2027. | — |
| ENHANCE Part B (heart) & DENOVO (lung) | Trials progressing | IDE supplement incorporating CHOPS submitted and under FDA review, expected approval late Q3/early Q4 with Lung IDE to follow; targets ~2,200 U.S. DBD hearts plus 2,000-5,000 incremental heart/lung cases; ENHANCE Part A to complete before year-end; CHOPS 510(k) a H1 2027 horizon. | — |
| International / European expansion | Early Europe entry | Replicating U.S. NOP/logistics model starting in Italy (regional machine-perfusion and services budgets ratified, effective late 2026/early 2027); competing in Italian logistics tenders; pursuing large existing logistics budgets in Netherlands, France and U.K.; viewed as a 2027+ catalyst. | — |
| PAD Aviation / European logistics | — | Closed July 1 investment in Paderborn, Germany (central 2-hour flight radius) for the aviation license, 40+ pilots and fleet to compete for European transplant-logistics tenders; a slower, more capital-cautious ramp than the U.S. Summit Aviation deal; not active in Germany itself (no DCD, reimbursement pending). | — |
| Vertically integrated moat | OCS + NOP + logistics + digital | Four hard-to-replicate assets (OCS, National OCS Program, Transplant Logistics Network, NOP Connect digital ecosystem); added Donor and Recipient Clinical Screening Coordination Services July 1 (piloting with a major Boston health system) to run more of the transplant workflow on the platform. | — |
| OPO recertification / CMS | Awaiting CMS rule | Awaiting a CMS decision (hoped in 2H 2026) on whether outside entities can become OPOs; a binary opportunity not embedded in any growth guidance; TransMedics ready to compete for DSAs but will grow regardless. | — |
| Long-term targets | 10,000 transplants by 2028; $2B+ revenue by 2032 | Reaffirmed ~10,000 transplants by 2028 on the current heart/lung/liver platform (excluding CHOPS and kidney); kidney and international drive 10,000->20,000 by 2030-2032 and the ~30,000-transplant / $2B+ revenue vision. | — |