(TMDX) 2023 Q3 法說會逐字稿

Good afternoon, and welcome to the TransMedics Third Quarter 2023 Earnings Conference Call. (Operator Instructions) As a reminder, this call is being recorded for replay purposes.

下午好，歡迎參加 TransMedics 2023 年第三季財報電話會議。 （操作員說明）謹此提醒，此通話正在錄音以供重播之用。

I would now like to turn the call over to Brian Johnston from the Gilmartin Group, for a few introductory comments.

我現在想將電話轉接給吉爾馬丁集團的布萊恩約翰斯頓，請其發表一些介紹意見。

Thank you. Earlier today, TransMedics released financial results for the quarter ended September 30, 2023. A copy of the press release is available on the company's website.

謝謝。今天早些時候，TransMedics 發布了截至 2023 年 9 月 30 日的季度財務業績。新聞稿的副本可在該公司網站上取得。

Before we begin, I would like to remind you that management will make statements during this call, including during the question-and-answer portion of the call, that include forward-looking statements within the meaning of Federal Securities laws. Any statements contained in this call that relate to expectations or predictions of future events, results or performance are forward-looking statements.

在我們開始之前，我想提醒您，管理層將在本次電話會議期間（包括電話會議的問答部分）發表聲明，其中包括聯邦證券法含義內的前瞻性聲明。本次電話會議中包含的任何與對未來事件、結果或績效的預期或預測相關的陳述均為前瞻性陳述。

All forward-looking statements, including, without limitation, our examination of operating trends, the potential commercial opportunity for our products and our future financial expectations, which include expectations for growth in our organization and guidance and/or expectations for revenue, gross margins and operating expenses in 2023 and beyond are based upon our current assumptions and estimates. These statements involve material risks and uncertainties that could cause actual results or events to materially differ from those anticipated or implied by these forward-looking statements. Accordingly, you should not place undue reliance on these statements.

所有前瞻性陳述，包括但不限於我們對營運趨勢的審查、我們產品的潛在商業機會以及我們未來的財務預期，其中包括對我們組織成長的預期以及對收入、毛利率和利潤的指導和/或預期。2023 年及以後的營運費用是基於我們當前的假設和估計。這些陳述涉及重大風險和不確定性，可能導致實際結果或事件與這些前瞻性陳述預期或暗示的結果或事件有重大差異。因此，您不應過度依賴這些陳述。

Additional information regarding these risks and uncertainties appears under the heading Risk Factors on our Form 10-K filed with the Securities and Exchange Commission on February 27, 2023, our subsequent Form 10-Q filings and the forward-looking statements included in today's earnings press release, which is available on our website and at www.sec.gov.

有關這些風險和不確定性的更多資訊請參閱我們於2023 年2 月27 日向美國證券交易委員會提交的10-K 表格、我們隨後提交的10-Q 表格以及今天的收益新聞稿中包含的前瞻性聲明中的「風險因素」標題發布，可在我們的網站和 www.sec.gov 上取得。

TransMedics disclaims any intention or obligation, except as required by law, to update or revise any financial projections or forward-looking statements, whether because of new information, future events or otherwise. This conference call contains time-sensitive information and is accurate only as of the live broadcast today, November 6, 2023.

除法律要求外，TransMedics 不承擔任何更新或修改任何財務預測或前瞻性聲明的意圖或義務，無論是由於新資訊、未來事件或其他原因。本次電話會議包含時效性訊息，僅截至 2023 年 11 月 6 日今天直播時準確。

And with that, I'll turn the call over to Waleed Hassanein, President and Chief Executive Officer.

接下來，我會將電話轉給總裁兼執行長 Waleed Hassanein。

Thank you, Brian. Good afternoon, everyone, and welcome to TransMedics Third Quarter 2023 Earnings Call. As always, joining me today is Stephen Gordon, our Chief Financial Officer.

謝謝你，布萊恩。大家下午好，歡迎參加 TransMedics 2023 年第三季財報電話會議。像往常一樣，今天與我一起出席的是我們的財務長 Stephen Gordon。

The third quarter was an important foundation building quarter for TransMedics. We closed 2 strategic acquisitions: one to position us for near-term growth with the Summit Aviation; and one to position us for long-term growth with Bridge to Life Technologies.

第三季是 TransMedics 重要的基礎建設季度。我們完成了 2 項策略性收購：一項是為了透過 Summit Aviation 實現近期成長；以及幫助我們透過 Bridge to Life Technologies 實現長期成長的目標。

Following the acquisition of Summit Aviation in August, our team worked diligently to meet our goal to try to initiate a limited launch of our transplant logistics service in late 3Q. We met this goal, and we started seeing early positive impact of logistics on revenue, on catalyzing NOP case volume and overall clinical adoption.

繼 8 月收購 Summit Aviation 後，我們的團隊努力工作，以實現我們的目標，即在第三季末有限地推出我們的移植物流服務。我們實現了這一目標，我們開始看到物流對收入、促進 NOP 病例數和整體臨床採用的早期正面影響。

This early momentum, combined with sustained growth demand for all 3 organ markets and solid OUS performance enabled us to achieve significant growth in 3Q. This was achieved despite operational and resource challenges we outlined in our second quarter call.

這種早期的勢頭，加上所有三個器官市場的持續成長需求和穩健的 OUS 業績，使我們在第三季度實現了顯著成長。儘管我們在第二季電話會議中概述了營運和資源挑戰，但還是實現了這一目標。

Here are the summary results for 3Q. Our total revenue was $66.4 million, representing 159% growth over the same period in 2022 and 27% sequential quarter-over-quarter growth from 2Q 2023. $64 million of the total $66.4 million was from transplant-related activities, including approximately $2.1 million in NOP Aviation and logistics-related revenue.

以下是第三季的總結結果。我們的總營收為6,640 萬美元，較2022 年同期成長159%，較2023 年第二季較上季成長27%。總營收6,640 萬美元中，有6,400 萬美元來自移植相關活動，其中約210 萬美元來自移植相關活動。NOP 航空和物流相關收入。

We are thrilled by the early performance of our transplant aviation and logistics service as it raises our confidence in our long-term plans, which I will cover later in the presentation today.

我們對移植航空和物流服務的早期表現感到興奮，因為它增強了我們對長期計劃的信心，我將在今天的演講中稍後介紹。

Approximately $2.4 million of the total revenue was attributable to legacy Summit charter and flight school operations. As we've stated before, we intend to exit the legacy charter business with diminishing contribution in Q4 before a full exit in early 2024. Meanwhile, we will maintain our flight school revenue, which will continue to be a part of our P&L going forward. Stephen will detail associated P&L impacts in his section of today's call.

總收入中約 240 萬美元來自遺留的 Summit 包機和飛行學校運營。正如我們之前所說，我們打算在 2024 年初全面退出之前，在第四季度退出貢獻逐漸減少的傳統包機業務。同時，我們將維持我們的飛行學校收入，這將繼續成為我們未來損益表的一部分。史蒂芬將在今天的電話會議中詳細介紹相關的損益影響。

Our team did a great job executing on all fronts. 3Q performance speaks volumes to their hard work, dedication and creativity. I want to take a moment and acknowledge our entire team at TransMedics for their efforts to help us achieve these great results.

我們的團隊在各方面都表現出色。第三季的表現充分說明了他們的辛勤工作、奉獻精神和創造力。我想花一點時間感謝 TransMedics 的整個團隊為幫助我們取得這些偉大成果所做的努力。

Now let me cover the specifics of Q3. In line with our growth strategy, we grew revenue across all 3 organ markets in the U.S. compared to 2Q. OUS revenues also grew sequentially. Stephen will cover the details in his section of today's call.

現在讓我介紹一下第三季的具體情況。根據我們的成長策略，與第二季度相比，我們在美國所有 3 個器官市場的收入都有所成長。 OUS 營收也持續成長。史蒂芬將在今天的電話會議中介紹詳細資訊。

Given the success of the NOP program and the flexibility it affords U.S. transplant programs to use it, going forward, we will primarily focus on the organ-specific revenue trends quarter-over-quarter instead of the number of centers. Let me repeat again. Going forward, we will primarily focus on organ-specific revenue trends quarter-over-quarter instead of the number of centers. This is because we no longer believe or see center numbers as an accurate predictor of growth in the NOP era.

鑑於 NOP 計劃的成功以及它為美國移植計劃提供使用該計劃的靈活性，展望未來，我們將主要關注逐季度特定器官的收入趨勢，而不是中心的數量。讓我再說一次。展望未來，我們將主要關注特定器官的季度環比收入趨勢，而不是中心的數量。這是因為我們不再相信或認為中心數據可以準確預測 NOP 時代的成長。

Beyond strong revenue growth, we also demonstrated continued operational efficiencies in 3Q as we continue to benefit from increasing scale and making further progress towards positive cash flow and profitability. In terms of NOP, we met our stated goal of having NOP contribute the lion's share of our U.S. revenue in 3Q as we reached an all-time high of 97% NOP contribution of the total U.S. cases.

除了強勁的收入成長之外，我們在第三季度還展示了持續的營運效率，因為我們繼續受益於規模的擴大以及在正現金流和盈利能力方面取得的進一步進展。就 NOP 而言，我們實現了讓 NOP 在第三季貢獻美國收入的最大份額的既定目標，因為我們達到了 NOP 占美國總病例數 97% 的歷史新高。

On a per organ basis, approximately 98% of liver, 93% of heart and 97% of lung cases were from NOP in 3Q. Given this success, we fully expect that we will transition out of the shrinking direct acquisition model in 2024.

從每個器官來看，第三季約 98% 的肝臟、93% 的心臟和 97% 的肺部病例來自 NOP。鑑於這一成功，我們完全預期我們將在 2024 年擺脫萎縮的直接收購模式。

To meet the growing demand for NOP and to overcome our clinical support staffing shortage we discussed in 2Q, we added 45 new clinical specialists and 10 surgeons in 3Q. We will continue to invest in this area throughout the remainder of '23 and in early '24 to prepare for the expected growth in '24 and beyond.

為了滿足對 NOP 不斷增長的需求並克服我們在第二季度討論的臨床支援人員短缺問題，我們在第三季度增加了 45 名新的臨床專家和 10 名外科醫生。我們將在 23 年剩餘時間和 24 年初繼續在這一領域進行投資，為 24 年及以後的預期成長做好準備。

From a volume perspective, we are well on our way to reaching our stated goal of completing more than 2,000 U.S. NOP transplants in 2023. This would represent more than doubling of our case volume from 2022.

從數量角度來看，我們正在順利實現我們的既定目標，即在 2023 年完成超過 2,000 例美國 NOP 移植手術。這意味著我們的病例數比 2022 年增加了一倍多。

Let me now turn to a more detailed discussion on our new logistics business. As we described on our 2Q call, TransMedics set out to develop a more efficient national transplant logistics model in the U.S. Our goal is to control the entire end-to-end process of donor to recipient logistics for all NOP transplant volume in the U.S. by the second half of 2024.

現在讓我更詳細地討論我們的新物流業務。正如我們在第二季度電話會議中所述，TransMedics 著手在美國開發更有效率的國家移植物流模式。我們的目標是控制美國所有 NOP 移植量的捐贈者到接受者物流的整個端到端流程： 2024年下半年。

By way of background and as a reminder, approximately 75% to 80% of NOP heart, lung and liver transplants require private charter air transportation to move transplant teams and organs from donor to recipient.

作為背景介紹並提醒大家，大約 75% 至 80% 的 NOP 心臟、肺和肝臟移植需要私人包機運輸，將移植團隊和器官從捐贈者轉移到接受者。

The rapid expansion of NOP, the increase in distance afforded by the protective effect of the OCS technology and our experience operating the NOP model in the U.S. over the past 18 months have clearly shown us that the current industry model is inefficient and unscalable in the era of NOP and the new national allocation laws.

NOP的快速擴張、OCS技術保護作用帶來的距離增加以及我們過去18個月在美國運營NOP模式的經驗都清楚地向我們表明，當前的行業模式在這個時代是低效且不可擴展的。NOP和新的國家分配法。

Our vision is that with a TransMedics developed and operated world-class efficient transplant dedicated logistics service, we can meaningfully drive additional growth of our NOP case volume and fueling overall revenue growth.

我們的願景是，透過 TransMedics 開發和營運世界一流的高效移植專用物流服務，我們可以有意義地推動 NOP 病例數量的進一步成長，並推動整體收入成長。

Late in Q3, we initiated a limited launch of our new transplant logistics business with aviation to solve these inefficiencies and support and expand our NOP case volume. We are extremely pleased with the early results. Despite expected early growing pains and inefficiencies as we integrate the Summit operation, 3Q truly represents the first inning of this important new TransMedics business offering.

第三季末，我們透過航空有限啟動了新的移植物流業務，以解決這些低效率問題，並支持和擴大我們的 NOP 病例量。我們對早期結果非常滿意。儘管我們在整合 Summit 業務時預計會遇到早期成長的陣痛和效率低下的情況，但第三季確實代表了 TransMedics 這一重要的新業務產品的第一局。

So far, we are thrilled by the early encouraging results. We are in the process of building out the fleet and adding additional staff to operate the fleet efficiently. As of today, we have acquired 8 planes. We plan to expand our fleet to around 15 to 20 operational planes by the second half of 2024. Rest assured that we will continue to assess this need based on data-driven approach.

到目前為止，我們對早期令人鼓舞的結果感到興奮。我們正在擴建機隊並增加更多人員以有效運作機隊。截至今天，我們已經購買了 8 架飛機。我們計劃在 2024 年下半年將我們的機隊擴大到約 15 至 20 架營運飛機。請放心，我們將繼續根據數據驅動的方法評估這一需求。

We have also initiated the build-out of our logistics, digital command and dispatch center in Andover, Massachusetts, and we expect it to be fully operational by Q1 of '24. This is important as it will drive significant efficiency to the dispatch operation for NOP clinical and logistical resources.

我們還啟動了在馬薩諸塞州安多佛的物流、數位指揮和調度中心的建設，我們預計該中心將在 24 年第一季全面投入營運。這很重要，因為它將顯著提高 NOP 臨床和後勤資源調度操作的效率。

I want to affirm that based on everything we know today, we are extremely confident and bullish on the potential positive impact of transplant logistics service on the growth of our NOP case volume and more efficient utilization of our clinical resources.

我想確認的是，根據我們今天所知道的一切，我們非常有信心和看好移植物流服務對我們 NOP 病例數量增長和更有效利用我們臨床資源的潛在積極影響。

Before I move on from logistics and aviation, let me share our expectations on our gross margin progression going forward. In 3Q, the inefficiencies associated with integrating Summit and streamlining the entire operation to focus on transplant was a bit of a headwind on our service margin. We expect this to improve over the next few quarters.

在我離開物流和航空之前，讓我先分享一下我們對未來毛利率成長的預期。在第三季度，與整合 Summit 和簡化整個營運以專注於移植相關的效率低下，對我們的服務利潤率產生了一些不利影響。我們預計這一情況將在未來幾季得到改善。

Let me be crystal clear. We fully expect both our product and service margins to improve over the next several quarters as we gain more operational leverage and efficiency. Simply stated, 3Q margins do not, I repeat, do not represent our long-term margins at all. The expected inefficiencies of integration -- simply stated, 3Q margins do not represent our long-term margins at all, given the expected inefficiencies of integration and transitioning of the Summit operations.

讓我說得一清二楚。我們完全預計，隨著我們獲得更多的營運槓桿和效率，我們的產品和服務利潤率將在未來幾季得到改善。簡而言之，我再說一遍，第三季利潤率根本不代表我們的長期利潤率。預期的整合效率低下——簡單地說，考慮到峰會業務整合和轉型的預期效率低下，第三季的利潤率根本不代表我們的長期利潤率。

Now let me turn to our mid and long-term plans. As we stated in our last call, we have a multifaceted strategy to leverage some of the technologies we acquired from Bridge to Life to accelerate our OCS NextGen program and expand our product offering. Our goal is to leverage these technologies and new clinical programs to drive our mid and long-term growth in NOP case volume to reach our stated goal of performing 10,000 NOP cases in the U.S. by 2028. We hope to have more to share about these new technologies and its associated clinical programs later in 2024.

現在讓我談談我們的中長期計劃。正如我們在上次電話會議中所述，我們制定了多方面的策略，利用我們從 Bridge to Life 獲得的一些技術來加速我們的 OCS NextGen 計劃並擴大我們的產品範圍。我們的目標是利技術及其相關臨床項目將於 2024 年稍後推出。

We are continuing to drive our business forward. And for the seventh consecutive quarter, we have demonstrated that we can grow our revenue and adoption of our OCS NOP cases. We are on track to meet our stated goal of doubling our NOP transplants to more than 2,000 in 2023. We are not stopping here, however, as we are determined to reach our goal of 10,000 transplants over the next 5 years.

我們正在繼續推動我們的業務向前發展。我們已經連續第七個季度證明，我們可以增加收入並提高 OCS NOP 案例的採用率。我們預計將實現既定目標，即到 2023 年將 NOP 移植量增加一倍，達到 2,000 例以上。然而，我們不會就此止步，因為我們決心在未來 5 年內實現 10,000 例移植的目標。

Given our strong 3Q results balanced with potential scalability challenges, we are increasing our annual revenue guidance for the full year '23 to be between $222 million and $230 million, up from our previously communicated guidance of $180 million to $190 million and representing 138% to 146% growth over the full year 2022 total revenue.

鑑於我們強勁的第三季業績與潛在的可擴展性挑戰相平衡，我們將23 年全年的年收入指引提高到2.22 億美元至2.3 億美元之間，高於我們先前傳達的1.8 億美元至1.9 億美元指導，佔2019 年全年營收指引的138%。較2022年全年總營收成長146%。

With that, let me turn the call to Stephen to cover the detailed financial results of the quarter. Stephen?

接下來，讓我致電史蒂芬，介紹本季的詳細財務表現。史蒂芬？

Thank you, Waleed. I will now detail our Q3 results and provide supplemental financial information for the quarter. Given the 2 acquisitions and evolving business model, I will move through the dialogue carefully and try to touch on all relevant points.

謝謝你，瓦利德。我現在將詳細介紹我們第三季的業績，並提供該季度的補充財務資訊。鑑於這兩次收購和不斷發展的商業模式，我將仔細進行對話，並嘗試觸及所有相關要點。

Starting with revenue. For the third quarter of 2023, our total revenue was $66.4 million. This is an increase of 159% from the third quarter of 2022 and a 27% sequential increase from last quarter. Of note, the $66.4 million of revenue for the quarter included $1.6 million of revenue related to Summit Aviation's legacy charter business. The legacy charter business is in the process of transitioning, and we intend to exit by early 2024. We expect the charter revenue should be minimal in Q4 and 0 as we enter 2024.

從收入開始。 2023 年第三季度，我們的總營收為 6,640 萬美元。這比 2022 年第三季成長了 159%，比上季環比成長了 27%。值得注意的是，該季度 6,640 萬美元的收入包括與 Summit Aviation 傳統包機業務相關的 160 萬美元收入。傳統包機業務正處於轉型過程中，我們打算在 2024 年初退出。我們預計第四季度的包機收入應為最低，進入 2024 年時為 0。

The $66.4 million of revenue also includes about $800,000 of revenue related to the flight school that was part of our acquisition of Summit Aviation. So taking into account the charter and flight school revenue, transplant-related revenue was $64 million.

6,640 萬美元的收入還包括與飛行學校相關的約 80 萬美元收入，這是我們收購 Summit Aviation 的一部分。因此，考慮到包機和飛行學校的收入，移植相關的收入為 6,400 萬美元。

Now as Waleed mentioned, included in this $64 million was our first transplant-related logistics revenue of $2.1 million. This logistics revenue was derived from missions that utilized our own logistics network. In the past, our hospital customers would have paid this to other logistics brokers. But this is now part of the service that we are providing. So we feel the $2.1 million in less than a full quarter is a very good start.

正如 Waleed 所提到的，這 6,400 萬美元中包括我們第一個與移植相關的物流收入 210 萬美元。該物流收入來自利用我們自己的物流網絡的任務。過去，我們的醫院客戶會將這筆費用支付給其他物流經紀人。但這現在是我們提供的服務的一部分。因此，我們認為不到一個完整季度的時間就獲得了 210 萬美元，這是一個非常好的開始。

In the U.S., U.S. transplant revenue for the quarter was $59.7 million. That's 156% growth from Q3 of 2022. And this includes the $2.1 million of logistics revenue. The organ breakdown on U.S. revenue was $41.2 million of liver, $15.1 million of heart and $3.4 million of lung. So let me just repeat that. $41.2 million of liver, $15.1 million of heart and $3.4 million of lung. Ex U.S. revenue was $4.3 million. It was $3.9 million of heart, $0.3 million of lung and $0.1 million of liver.

在美國，本季美國移植收入為 5,970 萬美元。與 2022 年第三季相比成長了 156%。其中包括 210 萬美元的物流收入。美國收入中的器官細分為肝臟 4,120 萬美元、心臟 1,510 萬美元和肺 340 萬美元。讓我重複一遍。肝臟價值 4,120 萬美元，心臟價值 1,510 萬美元，肺部價值 340 萬美元。美國以外的收入為 430 萬美元。其中心臟價值 390 萬美元，肺部價值 30 萬美元，肝臟價值 10 萬美元。

Now regarding the breakout of product and service revenue this quarter, service revenue is growing given the introduction of logistics and aviation. So product revenue was $47.7 million in Q3 of 2023 and service revenue was $18.7 million. And just reiterating, the service revenue includes the $2.4 million of nontransplant related revenue as part of the Summit acquisition, $1.6 million of the charter that's being transitioned out by early 2024 and $0.8 million of the flight school revenue. This we expect to recur, but it's not likely to grow. So the flight school will be less material as our transplant revenue grows.

從本季產品和服務收入的突破來看，由於物流和航空的引入，服務收入正在成長。因此，2023 年第三季的產品收入為 4,770 萬美元，服務收入為 1,870 萬美元。重申一下，服務收入包括作為 Summit 收購一部分的 240 萬美元非移植相關收入、將於 2024 年初過渡的 160 萬美元包機收入以及 80 萬美元飛行學校收入。我們預計這種情況會再次發生，但不太可能增加。因此，隨著我們移植收入的成長，飛行學校的物質將會減少。

Now turning to gross margin. Gross margin for the third quarter of 2023 was 61%. And as Waleed mentioned, this is lower than the Q2 of 2023 due to transient inefficiencies related to the Summit acquisition and limited launch of our transplant logistics offering. Beyond the integration, margin was also unfavorably impacted by legacy charter operations as we transition to focus exclusively on transplant missions.

現在轉向毛利率。 2023年第三季毛利率為61%。正如 Waleed 所提到的，這一數字低於 2023 年第二季度，因為與 Summit 收購相關的暫時效率低下以及我們移植物流服務的推出有限。除了整合之外，隨著我們轉向專門專注於移植任務，傳統包機業務也對利潤率產生了不利影響。

So our service margin was impacted by both of these. We had the old charter business trailing off, and we have the new transplant business beginning, but neither one was at scale in the quarter. In general, the higher mix of service does reduce the overall business gross margin. However, we fully expect the gross margin to improve in the coming quarters.

因此，我們的服務利潤率受到這兩者的影響。我們的舊包機業務逐漸減少，新的移植業務開始，但本季都沒有達到規模。一般來說，較高的服務組合確實會降低整體業務毛利率。然而，我們完全預計未來幾季的毛利率將會改善。

In simple and mathematical terms, our product margin this quarter was 77%, and we expect this to improve into the 80% range over the next few quarters. And the service margin was 21% in Q3. We also expect this to improve over the next few quarters to the low to mid-30% range.

用簡單的數學術語來說，我們本季的產品利潤率為 77%，我們預計在接下來的幾個季度中這一數字將提高到 80%。第三季服務利潤率為 21%。我們也預計這一情況將在未來幾季改善至 30% 的低至中範圍。

The mix in the quarter was 72% product and 28% service. In the future, we expect the mix to be about [70%-30%] product and service, which would equate to about a mid to upper 60% range for gross margin in the overall business, very much in line with our expectations.

本季的組合為 72% 產品和 28% 服務。未來，我們預期產品和服務的組合約為[70%-30%]，相當於整體業務的毛利率在60%左右，非常符合我們的預期。

So we do expect and are very confident that the gross margin will improve over the next several quarters starting in Q4 and into 2024. Given the higher mix of service in our business, we believe a mid to upper 60s gross margin is a reasonable steady state. And of course, as our logistics allows us to open up more cases and more product sales, the overall gross profit dollar contribution will be significantly higher than if we were not using our own logistics network. And this was true in this quarter, Q3, that we just finished as well.

因此，我們確實預計並非常有信心，從第四季度開始到2024 年，毛利率將在未來幾季有所改善。鑑於我們業務中的服務組合較高，我們認為60 多歲的毛利率是一個合理的穩定狀態。當然，由於我們的物流使我們能夠打開更多的箱子和更多的產品銷售，因此整體毛利貢獻將明顯高於我們不使用自己的物流網絡的情況。在我們剛完成的第三季也是如此。

Moving on to expenses. Total operating expenses for the third quarter of 2023 were $69 million. However, operating expenses include 2 acquisition transition -- excuse me, 2 acquisition transaction specific impacts.

繼續討論支出。 2023 年第三季的總營運費用為 6,900 萬美元。然而，營運費用包括 2 項收購過渡——請問，2 項收購交易的具體影響。

First, we have $27.2 million of acquired in-process research and development expenses related to our acquisition of the Bridge to Life Technologies. And secondly, included in SG&A is approximately $2.2 million of other acquisition-related expenses.

首先，我們有 2,720 萬美元的收購過程中的研發費用，這些費用與我們收購 Bridge to Life Technologies 相關。其次，SG&A 中包含約 220 萬美元的其他收購相關費用。

Now if we normalize for these 2 items, our underlying operating expense was $39.8 million. This is 68% above the third quarter of 2022 and 6% sequential growth from Q2 of '23. We have continued to make critical investments in the company to ensure scalability for growth and to support future growth while still growing expenses at a much lower rate than revenue.

現在，如果我們將這兩項標準化，我們的基本營運費用為 3,980 萬美元。這比 2022 年第三季成長 68%，比 2023 年第二季季增 6%。我們繼續對公司進行關鍵投資，以確保成長的可擴展性並支持未來的成長，同時支出的成長速度仍遠低於收入的成長速度。

Our operating loss was $28.3 million in the quarter of 2023 compared to $5.5 million in the third quarter of 2022. Taking into consideration the 2 transaction specific expense items I mentioned earlier, our operating income would have been just above breakeven for the quarter, about $900,000.

我們2023 年季度的營運虧損為2,830 萬美元，而2022 年第三季為550 萬美元。考慮到我之前提到的2 個交易特定費用項目，我們該季度的營運收入將略高於盈虧平衡點，約90 萬美元。

Our net loss for the third quarter of 2023 was $25.4 million compared to $7.4 million in the third quarter of '22. Total cash was $427.1 million as of September 30, 2023. In the quarter, we spent $42.1 million on the 2 business acquisitions as well as approximately $103 million on 8 jets that were added to our transplant logistics fleet. We are depreciating these jets over 10 years with a 50% residual value. Finally, weighted average common shares outstanding for the quarter were $32.6 million.

我們 2023 年第三季的淨虧損為 2,540 萬美元，而 2022 年第三季的淨虧損為 740 萬美元。截至2023 年9 月30 日，現金總額為4.271 億美元。本季度，我們在兩項業務收購上花費了4,210 萬美元，並在移植物流機隊中增加了8 架噴射機，花費了約1.03億美元。我們將在 10 年內對這些飛機進行折舊，殘值率為 50%。最後，本季已發行普通股的加權平均數為 3,260 萬美元。

Overall, we are extremely pleased with our Q3 financial results. We have demonstrated that adding our own aviation and logistics offering in Q3 allowed us to continue growing revenue at a strong pace. While we saw some headwinds on gross margin in this transitional quarter, I have full confidence in our ability to grow the gross margin to the mid-60s as we have described, after integrating our logistics offering. And this change in our business also showed that even with a lower gross margin, the gross profit dollars are growing, which clearly puts us on a path to profitability.

總的來說，我們對第三季的財務表現非常滿意。我們已經證明，在第三季度增加我們自己的航空和物流服務使我們能夠繼續強勁地成長收入。雖然我們在這個過渡季度看到了毛利率方面的一些阻力，但我對我們在整合物流服務後將毛利率提高到 60 年代中期的能力充滿信心。我們業務的這項變更也表明，即使毛利率較低，毛利也在成長，這顯然使我們走上了獲利之路。

As a concluding statement, I will repeat our updated revenue guidance for 2023 were $222 million to $230 million, which represents 138% to 146% growth.

作為結論性聲明，我將重申我們更新後的 2023 年收入指引為 2.22 億至 2.3 億美元，即 138% 至 146% 的成長。

Now I would like to turn the call back to Waleed for closing statements.

現在我想將電話轉回給瓦利德，讓其作結案陳詞。

Thank you, Stephen. Overall, the third quarter was a critical execution period for TransMedics as we integrated a new business, Summit Aviation, expanded our NOP clinical support capacity and launched a first-of-its-kind business to expand our NOP product and service offering.

謝謝你，史蒂芬。總體而言，第三季是 TransMedics 的關鍵執行期，因為我們整合了新業務 Summit Aviation，擴大了我們的 NOP 臨床支援能力，並推出了首個同類業務來擴大我們的 NOP 產品和服務範圍。

Despite the great results achieved, we firmly believe that we are setting up a great foundation to further accelerate our growth in '24 and beyond. We are extremely confident in our strategy and our ability to execute it to achieve our stated goal of 10,000 NOP transplant missions by 2028.

儘管取得了巨大的成果，但我們堅信，我們正在為 24 世紀及以後進一步加速成長奠定良好的基礎。我們對我們的策略以及執行該策略的能力非常有信心，以實現 2028 年實現 10,000 例 NOP 移植任務的既定目標。

With that, I will now turn the call to the operator for Q&A. Operator?

現在，我將把電話轉給接線員進行問答。操作員？

(Operator Instructions) The first question comes from Allen Gong with JPMorgan.

（操作員指令）第一個問題來自摩根大通的Allen Kong。

Can you hear me okay?

你聽得到我說話嗎？

Yes, Allen.

是的，艾倫。

I just want to make sure my line dropped for a second. Congratulations on the really good quarter. Just kind of to touch on it a bit, just the guidance, right? Just kind of doing my math, it looks like you're guiding to basically flat growth in fourth quarter. And you had highlighted that you are taking a little bit of a cautious stance on a few dynamics. So can you walk us through kind of what is leading to that caution? Is it the trends you're seeing so far in October? Or is it just the logistics of ramping up your aviation service model?

我只是想確保我的線路暫時掉線。恭喜這個非常好的季度。只是稍微談一下，只是指導，對吧？我算了一下，看起來你的指導方針是第四季基本上持平增長。您強調說，您對一些動態採取了謹慎的立場。那麼您能否向我們介紹一下導致這種謹慎的原因是什麼呢？這是您在 10 月到目前為止看到的趨勢嗎？還是只是為了加強航空服務模式的物流？

It's certainly the latter, Allen, 2 things. One, we are not fully staffed yet. We made significant progress in Q3. Our team was extremely creative to make us achieve the results we achieved, but we're not out of the woods yet. So that's number one. Number two is continuing to standing up the aviation business. Actually, what we've seen in October is actually extremely encouraging. We just need to make sure that we are cautious in our guidance to make sure that we still have these operational challenges for the rest of this year.

肯定是後者，艾倫，有兩件事。第一，我們的人員還沒有配備齊全。我們在第三季取得了重大進展。我們的團隊非常有創造力，使我們取得了所取得的成果，但我們還沒有擺脫困境。所以這是第一。第二是繼續支持航空業務。事實上，我們在十月所看到的情況實際上非常令人鼓舞。我們只需要確保我們在指導中保持謹慎，以確保我們在今年剩餘時間內仍然面臨這些營運挑戰。

And then I'm guessing it's probably a little early to be talking about 2024. But I think in the past, you've talked about your ambition. You obviously have your ambition for 2028. But when we think about the near term, you've talked about really wanting to continue doubling sales and number of transplants. So when we think about 2024, with the fact that not only will you have continued momentum in the Organ business, but now also a ramping contribution from Aviation, how should we think about your growth aspirations for 2024?

然後我猜現在談論 2024 年可能有點早。但我認為在過去，你已經談到了你的野心。您顯然對 2028 年有雄心壯志。但當我們考慮近期時，您談到確實希望繼續將銷售額和移植數量翻倍。因此，當我們考慮 2024 年時，您不僅在風琴業務上保持持續增長勢頭，而且現在航空業務的貢獻也不斷增加，我們應該如何考慮您 2024 年的增長願望？

Allen, we are not shy of sharing our aspiration and our ability to execute upon it. However, your reference point needs to be updated a little bit. We've tripled our revenue last year. We are on pace to double this year over last year. I think we will issue guidance for '24 in end of year call, but I want to be [cautioned] that our numbers are growing significantly. So that data point is a bit dated. But we're not issuing any guidance for '24 right now. We will do it in the first call in the year.

艾倫，我們並不羞於分享我們的願望和執行它的能力。但是，您的參考點需要稍微更新。去年我們的收入增加了兩倍。今年我們的業績將比去年翻倍。我認為我們將在年終電話會議中發布 24 小時的指導，但我想[警告]我們的數字正在顯著增長。所以這個數據點有點過時了。但我們目前不會發布 '24 的任何指南。我們將在今年的第一次通話中做到這一點。

Our next question comes from Bill Plovanic with Canaccord.

我們的下一個問題來自 Canaccord 的 Bill Plovanic。

Congratulations on a strong quarter. First, I think the most questions we're getting these days are related to the metrics or surrounding the aviation business. I think you gave us a little color on the gross margin, but of the whole services business, can you give us an idea of what you think kind of average revenue per case is, gross margin, operating margin per case? And then I think you projected or you said that maybe 75% to 80% of your current NOP could be with your own aviation applicable to that. Just trying to get some metrics around this, so we can kind of model this out?

恭喜季度表現強勁。首先，我認為我們這些天收到的最多問題都與指標或圍繞航空業務的問題有關。我認為您給了我們一些關於毛利率的信息，但是對於整個服務業務，您能否告訴我們您認為每個案例的平均收入、毛利率、每個案例的營業利潤是多少？然後我認為您預計或您說過，您目前的 NOP 的 75% 到 80% 可能與您自己的航空業適用。只是想得到一些關於這個的指標，所以我們可以對此進行建模？

Thanks, Bill. It's way too early to focus on that needed greatly details on the aviation. And we don't intend to share that anytime soon. Our most indicative metric to track is growth in revenue and improvement in the service margin. That's what we are going to be focusing on, and we believe it's the most indicative of healthy operation, both from the service and the product revenue.

謝謝，比爾。現在關注航空方面所需的大量細節還為時過早。我們不打算很快分享這一點。我們要追蹤的最具指示性的指標是收入的成長和服務利潤的改善。這就是我們要關注的重點，我們相信無論是從服務或從產品收入來看，這都是最能體現健康運作的。

On the second one, of course, our intention is to cover almost 100% of our NOP cases with our aviation. But we have to be realistic. We need to make sure that we beef up the fleet first, get all of our support staff, the pilots, the dispatch operations stood up. That's why we expect to be doing the lion's share of the NOP cases by the second half of next year, not before that. But our goal is to do as many of those cases ourselves, given, of course, what we see as a huge benefit on all fronts when we do that.

當然，對於第二個問題，我們的目的是透過我們的航空來涵蓋幾乎 100% 的 NOP 病例。但我們必須現實一點。我們需要確保先加強機隊，讓所有支援人員、飛行員和調度部門都站起來。這就是為什麼我們預計在明年下半年而不是之前處理大部分 NOP 案件。但我們的目標是自己做盡可能多的案例，當然，我們認為這樣做會為所有方面帶來巨大的好處。

And I mean, we don't have visibility into the metrics, but just a ballpark. On average, what's a typical case revenue that gets -- that you've seen kind of push through the hospitals to reimburse for an average case [on] the revenue for aviation specifically, how should we think about that?

我的意思是，我們無法了解指標，只能了解一個大概。平均而言，典型病例的收入是多少——您已經看到醫院透過航空收入來償還平均病例的收入，我們應該如何考慮這一點？

Sure. So Bill, I want to be cautious. This is not a question. This is a fact of organ transplant. Old aviation and logistics transport are fully reimbursed through the same mechanism of organ acquisition. There's no limit per se. In fact, we are doing this because we believe we could be more efficient and pass some of the efficiencies back to the transplant program.

當然。所以比爾，我想保持謹慎。這不是一個問題。這是器官移植的事實。舊的航空和後勤運輸透過相同的器官獲取機制得到全額報銷。本身沒有限制。事實上，我們這樣做是因為我們相信我們可以提高效率，並將部分效率回饋給移植計劃。

So I do not want anybody on this call to think that the aviation business is not reimbursed through normal mechanisms of organ transplant. There is no limit. There is no specifics. If the center feels that it's too expensive, they would ask for another [quote] or get from another vendor. But it's fully reimbursed. It's not a question of reimbursement. It's a question of making sure that we have the fleet, the efficiencies, the support team to be able to cover the missions.

因此，我不希望這次電話會議中的任何人認為航空業務無法透過正常的器官移植機制得到報銷。沒有限制。沒有具體細節。如果中心覺得太貴，他們會要求另一個[報價]或從其他供應商取得。但已經全額報銷了。這不是報銷的問題。問題是要確保我們擁有能夠執行任務的機隊、效率和支援團隊。

As far as the average, again, it's too early. It depends. If you're flying shorter distances, the average is somewhere between $25,000 to $30,000. If you're flying longer distances, it could go as high as $100,000. So it's really -- it depends on what type of missions you're flying.

就平均而言，現在還為時過早。這取決於。如果您飛行的距離較短，平均費用在 25,000 美元到 30,000 美元之間。如果您飛行距離較長，費用可能高達 100,000 美元。所以這實際上取決於你執行的任務類型。

And again, our goal is to gain efficiencies first, gain volume. The Q3 results is just really the first inning, not even early innings, it's the first inning. So we're looking forward to achieving more, building more confidence and sharing more detail as we build the fleet and build the operational efficiency we are foreseeing here.

再說一遍，我們的目標是先提高效率，然後增加產量。第三季的結果其實只是第一局，甚至不是早期局，它只是第一局。因此，我們期待在建造機隊和提高我們在這裡預見的營運效率時取得更多成就，建立更多信心並分享更多細節。

And then last question, I promise. Just on the fleet, a couple of things. One, you ended the quarter with $427 million in cash. I think there's been [8 case], you've acquired 8 planes. And if my memory serves me correct, you were looking to acquire 8 more, which -- $427 million, if it's $12 million a plane, that will leave you with over $300 million in cash. And I think not to take words out of Stephen's mouth, but your core business, stripping everything out was actually profitable by almost $1 million. Am I missing something here? Does that math add up?

然後是最後一個問題，我保證。就艦隊而言，有幾件事。第一，本季末您的現金為 4.27 億美元。我認為有[8 例]，你已經買了 8 架飛機。如果我沒記錯的話，您還想再購買 8 架，即 4.27 億美元，如果一架飛機價值 1200 萬美元，那麼您將擁有超過 3 億美元的現金。我想，不是從史蒂芬嘴裡說出來的，但你的核心業務，剝離一切，實際上盈利了近 100 萬美元。我在這裡錯過了什麼嗎？這個數學加起來嗎？

You're not missing anything, Bill. You got it exactly right.

你沒有錯過任何東西，比爾。你說得完全正確。

The next question comes from Suraj Kalia with Oppenheimer.

下一個問題來自蘇拉吉·卡利亞和奧本海默。

Can you hear me all right?

你聽得到我說話嗎？

Yes.

是的。

Gentlemen, congrats on a great quarter. So Waleed, I know you're shying away for obvious reasons from giving some of these metrics, but I have to ask. Waleed, give us some idea -- in your prepared remarks, you mentioned that your team was creative in meeting demand. Help us understand -- in terms of dry runs and mist runs, how should we think about that? How did you all handle that in this quarter, particularly?

先生們，恭喜您度過了一個美好的季度。所以瓦利德，我知道你出於明顯的原因迴避提供其中一些指標，但我不得不問。 Waleed，請給我們一些想法—在您準備好的發言中，您提到您的團隊在滿足需求方面具有創造力。幫助我們理解－就乾跑和霧跑而言，我們該如何思考？特別是本季你們都是如何處理這個問題的？

Sure. Thank you, Suraj. My prepared remarks really was addressing the fact that we were able to achieve these great results despite the fact that we were still building our clinical support team. So really, our team went out of their way to make sure that we cover as many of the cases as we can and minimize the impact of limited clinical staffing on our performance. That's one aspect of it.

當然。謝謝你，蘇拉吉。我準備好的發言實際上是在討論這樣一個事實：儘管我們仍在建立我們的臨床支援團隊，但我們仍然能夠取得這些偉大的成果。事實上，我們的團隊竭盡全力確保我們涵蓋盡可能多的病例，並盡量減少有限的臨床人員對我們績效的影響。這是它的一方面。

The second aspect is of our logistics team. We were operating with very, very small fleet and very small staffing. And we went out of the way to make sure that we cover those cases efficiently as much as we can and the results speak for themselves. So, that's really what the prepared remarks was intending to show.

第二個面向是我們的物流團隊。我們的車隊和人員配置非常非常小。我們竭盡全力確保我們盡可能有效地涵蓋這些案例，結果不言而喻。所以，這確實是準備好的言論想要表達的內容。

As far as the rate of dry runs, dry runs -- as I stated several times, dry runs is the nature of the DCD donation. It's going to be with us. As long as we have DCD donors, there's always going to be a case where the DCD -- potential DCD donor doesn't progress to DCD. And as long as we're using DCD donors, this is going to be the norm for us as we go forward. As far as the trend we saw in the quarter, I would say it was -- the rate of DCD donors progressing or lack of progression of DCD donors was a little bit below Q2, but that's all I can comment on. But there's always DCD -- lack of progression when you're using DCD donors.

就試運行率而言，試運行——正如我多次指出的，試運行是 DCD 捐贈的本質。它將與我們同在。只要我們有 DCD 捐贈者，就總是會存在 DCD——潛在的 DCD 捐贈者不會進展為 DCD 的情況。只要我們使用 DCD 捐贈者，這將成為我們前進的常態。就我們在本季看到的趨勢而言，我想說的是——DCD 捐贈者進展或缺乏進展的比率略低於第二季度，但這就是我能評論的全部。但總是存在 DCD——當您使用 DCD 供體時缺乏進展。

And Waleed, for my second question, I know when we were at your -- during the site visit, if memory serves me right, you had indicated that 70%, or north of 70% of all DCD Hearts, TransMedics was capturing those. I'd love to get some updated color from you, especially in Hearts, how do DCD and DBD trajectories look like? If you could also characterize how you think TransMedics' share progression within these subcategories is moving?

Waleed，關於我的第二個問題，我知道當我們在現場訪問時，如果我沒記錯的話，您曾表示，TransMedics 正在捕獲所有 DCD Hearts 的 70%（或 70% 以上）。我很想從你那裡得到一些更新的顏色，特別是在《紅心大戰》中，DCD 和 DBD 軌跡是什麼樣的？您是否也可以描述一下您認為 TransMedics 在這些子類別中的份額進展如何變化？

Thank you, Suraj. I appreciate the call -- I appreciate the question. So let me address the 2-part question you asked. The first is, yes, TransMedics continue to do the lion's share of DCD Heart donation in the United States. We expect to release the annualized number after -- by year-end when the full number of DCD Hearts are released. But from where we see it here, we are continuing to be north of 70%, for sure.

謝謝你，蘇拉吉。我感謝你的來電——我感謝你提出這個問題。因此，讓我回答您提出的由兩部分組成的問題。首先，是的，TransMedics 繼續承受美國 DCD 心臟捐贈的大部分。我們預計在年底前發布年化數字，屆時 DCD 之心的全部數量將發布。但從我們這裡看到的情況來看，我們肯定仍處於 70% 以上。

As I stated many times publicly, DCD is the low-hanging fruit right now because it's the sort of the black and white option to growing U.S. transplant volumes. That's why we expect to see the overall heart, lung and liver transplant to grow this year over last year because of the high use of DCD donors, especially in heart and liver that is afforded by OCS.

正如我多次公開指出的那樣，DCD 是目前唾手可得的成果，因為它是增加美國移植量的黑白選擇。這就是為什麼我們預計今年的心臟、肺和肝臟移植總量將比去年有所增長，因為 DCD 捐贈者的使用率很高，尤其是 OCS 提供的心臟和肝臟移植。

Now that doesn't mean that DBD were not -- DBD is not being used. The opposite is true. I would say, so far, it's -- between 45% to 50% of our volumes are DBD. We expect to see that growing in '24 and beyond as we are now highlighting the benefits. There will be some data readouts. There are some publications coming up in early '24 that will clearly point out the importance of using DBD organs to expand the donor pool even further. So we are confident that as we move forward, the DBD and DCD portion of our business will continue to grow, and we will continue to achieve high success rates on both.

但這並不意味著 DBD 沒有被使用——DBD 沒有被使用。事實恰恰相反。我想說，到目前為止，我們的銷量中有 45% 到 50% 是 DBD。我們預計這種情況會在 24 年及以後出現增長，因為我們現在正在強調其好處。將會有一些數據讀數。 24 年初將出版一些出版物，其中將明確指出使用 DBD 器官進一步擴大捐贈者庫的重要性。因此，我們相信，隨著我們的前進，我們業務的 DBD 和 DCD 部分將繼續成長，並且我們將繼續在這兩個方面取得高成功率。

Our next question comes from Ryan Daniels with William Blair.

我們的下一個問題來自瑞安·丹尼爾斯和威廉·布萊爾。

(technical difficulty) for you there. I know there was a little bit of controversy on NRP over the last few quarters and just demand in the market with DCD for that. But we've actually heard recently in our channel checks that many systems, especially nonprofits, are just banning NRP outright due to ethical issues. So I'm curious if you've seen that in the market where that's actually started to face some bans across the United States?

（技術難度）給你。我知道過去幾季對 NRP 存在一些爭議，而市場上對此有 DCD 的需求。但實際上，我們最近在通路檢查中聽說，許多系統，尤其是非營利組織，由於道德問題而徹底禁止 NRP。所以我很好奇你是否在市場上看到這種情況實際上已經開始面臨美國各地的一些禁令？

Ryan, as I stated last call, and you're absolutely right, we are not concerned at all about the progression of NRP. We are seeing the opposite is true. We're seeing many centers that uses NRP are now -- used to use NRP and now shifting to OCS. Again, we are doing more than 70% of the DCD Hearts in the United States. So I'm not concerned at all. NRP, it's going to be limited in nature.

Ryan，正如我在上次電話會議中所說的那樣，你說得完全正確，我們根本不關心 NRP 的進展。我們看到事實恰恰相反。我們看到許多使用 NRP 的中心現在都使用 NRP，現在轉向 OCS。同樣，我們在美國生產超過 70% 的 DCD Hearts。所以我一點也不擔心。 NRP，本質上是有限的。

We have -- Our results is pointing to that. And we have a couple of abstracts at the upcoming ISHLT that will address this point directly and clearly show the importance of OCS and capabilities of OCS, including cost comparison between OCS and NRP. Because for a while, there was a misunderstanding and misnomer that OCS might be more expensive than NRP. The opposite is true. So TransMedics -- the bottom line is TransMedics is doing the lion's share of DCD Hearts in this country. We expect that to continue to be the case. And ultimately, at some point, we'll probably be doing the vast majority of it. We are proud with where we are. We trust our technology, we trust our methods because it eliminates all these ethical and legal concerns that exist around NRP.

我們的結果表明了這一點。我們在即將舉行的 ISHLT 上有一些摘要，將直接討論這一點，並清楚地展示 OCS 的重要性和 OCS 的功能，包括 OCS 和 NRP 之間的成本比較。因為有一段時間，有誤解和誤稱，認為 OCS 可能比 NRP 更貴。事實恰恰相反。因此，TransMedics 的底線是 TransMedics 正在做這個國家 DCD Hearts 的大部分工作。我們預計這種情況將持續下去。最終，在某個時候，我們可能會完成其中的絕大多數。我們對我們所處的位置感到自豪。我們相信我們的技術，我們相信我們的方法，因為它消除了圍繞 NRP 存在的所有這些道德和法律問題。

And then I guess the additional question, and I'll hop back in the queue. Really good progress adding clinical staff. I think you said 45 new clinical staff and 10 surgeons. Can you speak a little bit to how that progressed through the quarters? Did you see the benefit for the full quarter? Was that kind of spread throughout the quarter? And then how should we think about the investments there in the fourth quarter to get to the scale you need to continue to grow into 2024? And congrats again.

然後我猜出附加問題，然後我會跳回隊列。增加臨床人員確實取得了很好的進展。我想你說的是 45 位新臨床人員和 10 位外科醫生。能否簡單介紹一下本季的進展？您看到整個季度的收益了嗎？這種情況在整個季度都有蔓延嗎？那麼我們該如何考慮第四季的投資，以達到 2024 年繼續成長所需的規模？再次恭喜。

Thank you, Ryan. I think -- to be fair, I think this came mainly through the second half of the quarter. So they contributed some, but not significantly. We expect those to contribute more in Q4, and we will continue to make investment in building out the clinical support staffing in Q4 to prepare for '24 and beyond. So this is going to be a fountain that doesn't stop given because as we see more and more growth we would need more and more clinical support staffing. And Tamer and his team are doing a great job in getting them trained and deployed to the field. But we will see the impact of these 45 new hires in Q4. And as we ramp up in Q4, it's mainly to see the impact in early '24.

謝謝你，瑞安。我認為——公平地說，我認為這主要是在本季後半段發生的。所以他們貢獻了一些，但並不顯著。我們預計這些人員將在第四季度做出更多貢獻，我們將在第四季度繼續投資建立臨床支援人員，為 24 世紀及以後做好準備。因此，這將是一個不會停止提供的源泉，因為隨著我們看到越來越多的成長，我們將需要越來越多的臨床支援人員。 Tamer 和他的團隊在培訓和部署到現場方面做得非常出色。但我們將在第四季看到這 45 名新員工的影響。當我們在第四季加大力度時，主要是為了看到 24 年初的影響。

Our next question comes from Josh Jennings with TD Cowen.

我們的下一個問題來自 TD Cowen 的 Josh Jennings。

Congrats on the really strong results. I wanted to just ask on 2 things really you said on your prepared remarks, I think. The first was just center numbers. You don't believe it's an accurate predictor of growth anymore. I hope I'm not asking you to repeat yourself on some of the other questions that you've answered already. But can you just give us a little bit more detail on why center numbers are not an active predictive growth and just build on that (inaudible)?

恭喜您取得了非常強勁的成績。我想我想問的是你在準備好的發言中所說的兩件事。第一個只是中心數字。您不再相信它是成長的準確預測指標。我希望我沒有要求您重複您已經回答過的其他一些問題。但是，您能否提供我們更多細節，說明為什麼中心資料不是主動預測成長，並在此基礎上進行建置（聽不清楚）？

Sure. Thank you, Josh. Really, what I meant by saying that, Josh, is, as long as we're growing our revenue per organ segment quarter-over-quarter, that is -- for us, that is the most strongest indicator of our growth. With NOP, as you know, I mean, every quarter, we get a handful of centers that never use the OCS in their life -- in our life, and they jump in into the NOP. Most of those continue on growth, but some of them may -- they slip 1 month and then come back again, some continues every month. It's -- All I'm trying to say is it's becoming noisy to be looking at the center-to-center -- quarter-to-quarter center growth.

當然。謝謝你，喬許。事實上，喬什，我所說的意思是，只要我們每個器官細分市場的收入逐季增長，對我們來說，這就是我們成長的最強有力的指標。如你所知，對於 NOP，我的意思是，每個季度，我們都會遇到一些在他們的生活中（在我們的生活中）從未使用過 OCS 的中心，他們跳入了 NOP。其中大多數繼續增長，但其中一些可能會下滑 1 個月，然後又回來，有些每個月都會繼續增長。我想說的是，關注中心之間、季度之間的中心成長變得很吵鬧。

The other thing is, and that's the most important is for liver and heart, we're already at a critical massive centers. We're already north of 40 centers for heart and liver. So growing -- beyond that it's mostly growing within the center, i.e., increasing the adoption and penetration within the center. That's important.

另一件事是，最重要的是對於肝臟和心臟來說，我們已經處於一個重要的大型中心。我們已經擁有 40 個心臟和肝臟中心。如此增長——除此之外，它主要是在中心內增長，即增加中心內的採用和滲透。這很重要。

The lung, until we have a new clinical program in lung, it's going to be few centers doing the lung. But this quarter was the largest anyway, and it's reflective of the lung revenue. That's what we're saying. We want to be not confusing the market with too much data that really may not track the growth. The growth is tracked by the quarter-to-quarter progression of per organ revenue. That is the most accurate indicator of growth.

肺部，在我們有一個新的肺部臨床計劃之前，將會有很少的中心進行肺部治療。但無論如何，這個季度是最大的，它反映了肺部收入。這就是我們所說的。我們希望不要用太多可能無法追蹤成長的數據來混淆市場。這一增長是透過每個器官收入的季度進展來追蹤的。這是最準確的成長指標。

And can we read through that -- on that commentary that, I think you've been reporting regular users versus center (technical difficulty) as well as the metric of centers that have enlisted TransMedics and with the NOP service in the quarter. But is that with capacity expanding that delta, and those metrics are just not important and as you said, not an active predictor of growth?

我們可以通讀一下嗎？關於該評論，我認為您一直在報告常規用戶與中心（技術難度）的比較，以及本季度已加入 TransMedics 和 NOP 服務的中心的指標。但是，隨著容量的擴大，這些指標是否就不重要了，正如您所說，不是成長的正面預測指標？

Exactly. That's exactly what we're saying, Josh.

確切地。這正是我們要說的，喬許。

My follow-up was something that we talked about, I think, at a headquarter visit this quarter. Just in my notes, I had you saying that the payers are saving money with NOP cases, and there's a desire from payers -- for centers to adopt NOP and use TransMedics as a service. Hoping you could just build on that and just how much interaction does your company have (inaudible) payers and anything you can add just to that, that payers are saving money with each NOP case?

我想，我的後續行動是我們在本季訪問總部時討論過的。就在我的筆記中，我讓您說付款人透過 NOP 案例省錢，並且付款人希望中心採用 NOP 並使用 TransMedics 作為服務。希望您能以此為基礎，以及您的公司與（聽不清楚）付款人有多少互動，以及您可以添加的任何內容，即付款人在每個 NOP 案例中都省錢了？

Sure Josh. Let me clarify Josh's question. The comments we made during the team from [Cowen's] visit here is absolutely true. What we're referring to is with NOP -- the growth of NOP have demonstrated a significant economic benefit of using OCS NOP across the chain of a patient needing an organ transplant. Starting with accessing more organ lowers the patient wait time on awaiting us. That's one of the biggest cost driver to insurance companies, keeping patients waiting on the waiting list in an ICU environment, sometimes even supported -- maximum supported in an ICU environment. So that's number one.

當然，喬許。讓我澄清一下喬希的問題。我們團隊在[考恩]訪問這裡期間發表的評論絕對正確。我們指的是 NOP——NOP 的成長已經證明了在需要器官移植的患者的整個鏈條中使用 OCS NOP 具有顯著的經濟效益。從獲取更多器官開始可以縮短患者等待我們的時間。這是保險公司最大的成本驅動因素之一，讓患者在 ICU 環境中排隊等候，有時甚至得到支持——在 ICU 環境中得到最大程度的支持。所以這是第一。

Number two, we're seeing the post-transplant surgical procedures that cost -- add additional cost to the case rate dropping significantly. For example, post-transplant bleeding, post-transplant take down to the OR, re-transplantation, post-transplant procedures like ECP is growing down significantly. And that's what's causing the payers to say we're seeing the benefits of -- it's really driven by more organs. With more organs, you're really driving the cost efficiency or the health economics of an organ transplant significantly to a transplant payer, and that's what we're seeing and what we're hearing.

第二，我們看到移植後外科手術的成本增加了額外成本，導致個案發生率顯著下降。例如，移植後出血、移植後送入手術室、再次移植、ECP 等移植後程序顯著減少。這就是為什麼付款人說我們看到了它的好處——它實際上是由更多的器官驅動的。有了更多的器官，您確實可以顯著提高器官移植的成本效率或健康經濟效益，這對移植付款人來說是重要的，這就是我們所看到和聽到的。

We are in constant communication and dialogue with some of the major payers in the United States. However, we're seeing more and more centers now are picking up that mantle and having their own discussion with their own business cases to their payers with significant success. We just held multiple forums here in Boston in mid-October, and many programs highlighted to the rest of the community, their success in growing their transplant volume from OCS and their positive discussion with payers -- commercial payers, given the significant success they've achieved in growing their volume.

我們與美國的一些主要付款人保持著持續的溝通和對話。然而，我們現在看到越來越多的中心正在承擔起這一職責，並就自己的業務案例向付款人進行討論，並取得了巨大的成功。我們剛剛在10 月中旬在波士頓舉辦了多個論壇，許多項目向社區其他成員強調了他們在增加OCS 移植量方面所取得的成功，以及他們與付款人（商業付款人）的積極討論，因為他們取得了巨大的成功。已經在數量上取得了增長。

So we continue to believe that this is going to continue with us. And the key for us is to make sure that we continue to laser focus on outcomes and the quality of care we're providing. If we do that right, the rest is going to be a pretty straightforward execution challenge.

因此，我們仍然相信這種情況將持續下去。對我們來說，關鍵是確保我們繼續專注於結果和我們提供的護理品質。如果我們做得正確，剩下的將是一個非常簡單的執行挑戰。

The next question comes from Bill Plovanic with Canaccord Genuity.

下一個問題來自 Canaccord Genuity 的 Bill Plovanic。

Actually, I tried to get back out of the queue, you've answered my question.

事實上，我試圖退出隊列，你已經回答了我的問題。

This concludes our question-and-answer session. I would like to turn the conference over to Waleed Hassanein for any closing remarks.

我們的問答環節到此結束。我想請瓦利德·哈薩因 (Waleed Hassanein) 發表閉幕詞。

Thank you so much for your time this evening, and we're looking forward to following up and looking forward to our next call. Thank you. Have a great evening, everyone.

非常感謝您今晚抽出寶貴的時間，我們期待著跟進並期待我們的下一次通話。謝謝。祝大家有個愉快的夜晚。

The conference has now concluded. Thank you for attending today's presentation. You may now disconnect.

會議現已結束。感謝您參加今天的演講。您現在可以斷開連線。