- Revenue Growth: Q4 2025 revenue reached $160.8M (32% YoY, 12% sequential), with full-year revenue hitting $605.5M (37% YoY growth).<br>
- Operating Profit Expansion: Q4 operating profit of $21.3M (13.2% margin), rising to $108.6M for 2025 (18% of total revenue).<br>
- Transplant Logistics Growth: Transplant logistics revenue surged 32% YoY to $28.6M, driven by OCS adoption and service scalability.<br>
- Transplant Volumes: U.S. OCS transplants jumped to 5,139 in 2025 (26% of total U.S. transplants), up 26% from 3,735 in 2024.<br>
- 2026 Guidance: Revenue projected at $727–$757M (20–25% YoY growth), supported by OCS ENHANCE, DENOVO, and international expansion.<br>
Revenue Growth and Segment Performance
For the full year 2025, TransMedics achieved total revenue of $605.5 million, marking a 37% year-over-year growth. U.S. transplant revenue grew 38.6% year-over-year, while international transplant revenue grew 9.3%. The company's OCS transplant volumes increased, with 5,139 total U.S. OCS transplants performed in 2025, up from 3,735 in 2024, representing approximately 26% of the total U.S. transplants for the year. The transplant logistics service revenue grew 32% year-over-year to $28.6 million.
Profitability and Margin Expansion
The company's gross margin for the full year was 59.9%, up from 59.4% in 2024, reflecting logistics efficiencies and scale benefits. Operating expenses were $254 million, up 13% year-over-year, driven by a 23% increase in R&D investments. Operating margin expanded from 8.5% in 2024 to 18% in 2025. Net profit for the year was $190 million, compared to approximately $36 million in 2024. The company ended the year with $488 million in cash, driven by strong operating cash generation and disciplined working capital management.
Outlook and Valuation
TransMedics is guiding for revenue growth of 20% to 25% in 2026, driven by increased order utilization, continued OCS adoption, and expansion of service revenue. The company's gross margin is expected to remain around 60% over the long term. With a current P/E Ratio of 23.71 and P/S Ratio of 7.44, the market is pricing in significant growth expectations. The company's ROE is 53.88%, indicating strong profitability. Analysts estimate next year's revenue growth at 17.5%, slightly below the company's guidance.
Investment Drivers and Risks
The company's investments in R&D, particularly in the OCS ENHANCE and DENOVO programs, are expected to drive long-term growth. However, these investments are also expected to pressure operating margins in the near term. The company expects operating margins to approach 30% by 2028. Waleed Hassanein addressed concerns about the competitive landscape, stating that they have a plan to address issues in the Part B of the ENHANCE trial and will work with transplant programs to find an acceptable control arm for the FDA.