Specifically, we're very encouraged by the year-over-year growth trend, which we strongly believe is a more relevant and meaningful performance metric, especially in a seasonal quarter like Q3. Total revenue for Q3 2025 was approximately $144 million, or exactly $143.8 million, representing approximately 32.2% growth year-over-year. We experienced year-over-year growth across all three organ segments, driven by higher overall utilization and center penetration of OCS NOP in the U.S. Specifically, we saw year-over-year growth of nearly 41% in liver, approximately 14% in heart, and approximately 5% in lung revenues in Q3.
Our overall gross margin for Q3 was approximately 59%, representing 2.9% growth year-over-year. We delivered operating profit of approximately $23.3 million in Q3, representing more than 16% of total revenue, up from $3.9 million or approximately 4% of total revenue in Q3 2024. Transplant logistics service revenue for 3Q was $27.2 million, representing approximately 35% year-over-year growth. Now, please allow me to discuss our effort to expand our TransMedics National OCS Program model outside of the U.S., which represents a key midterm growth driver for TransMedics.
This initiative will serve as an additional growth catalyst beginning as early as late 2026 and more meaningfully in 2027 and beyond. We are expanding our OPO partnership to increase organ utilization for transplantation around the United States. Continued benefits from our ongoing strategic investments drive solid performance across both product and service lines, along with continued margin expansion and improved profitability versus Q3 of 2024. It's worth noting that in our earlier years, our rapid growth trajectory offset the natural seasonality in U.S.
| Metric | Period | Current guidance |
|---|---|---|
| Full-year revenue | FY2025 | narrowed to $595M-$605M, approximately 36% growth over 2024 at the midpoint |
| Operating margin expansion vs prior year | FY2025 | at least 750 basis points of operating margin expansion for full-year 2025 vs 2024, with possible additional upside |
| Gross margin | Coming years | around 60%, with potential near-term pressure from international expansion that is expected to normalize |
| Clinical trial revenue contribution | Q4 2025 | minimal/minuscule; first handful of patients to enroll in heart and lung in Q4 with near-zero revenue contribution |
| Metric | YoY | Note |
|---|---|---|
| Total revenue | approximately +32.2% | Higher overall utilization and center penetration of OCS NOP in the U.S. across all three organ segments. |
| U.S. transplant revenue | +32% | Continued momentum across liver ($108M) and heart ($27M) programs, partially offset by typical Q3 seasonal moderation that drove a 9% sequential decline. |
| Logistics revenue | +35% | Continued expansion and strong utilization of the aviation fleet versus 2024, though down 9% sequentially with the seasonal volume slowdown. |
| Gross margin | up nearly 290 bps to ~59% | Higher fleet utilization, cost efficiencies in logistics, limited unplanned aircraft downtime, and more evenly spread scheduled maintenance. |
| Operating income | +494% | Strong top-line growth with operating leverage; operating expenses up only 8% year-over-year against revenue up approximately 32%. |
| Net income | +477% | Strong operating performance and efficiency gains; EPS of $0.71 and diluted EPS of $0.66. |
| Topic | Previous mention | Current period | Trend |
|---|---|---|---|
| Seasonality in U.S. transplant activity | Rapid growth previously masked natural seasonality | At greater scale, results follow underlying market seasonality more closely; Q3 softness viewed as transient with volume rebounding in September and early Q4. | — |
| ENHANCE Heart and DENOVO Lung clinical programs | — | Several U.S. centers approaching enrollment; first patients and first revenue expected in Q4 2025 under conditional approval (heart Part A and Part B sizable; lung more limited), with all IDE conditions expected satisfied by early 2026. | — |
| International / NOP Europe expansion | — | First ex-U.S. NOP program announced in Italy with up to four hubs covering northern and southern Italy, planning an EU air and ground logistics network, launch expected first half of 2026 as a catalyst in late 2026 and more meaningfully in 2027+. | — |
| Double-shifting fleet pilot | — | Pilot underway to maximize existing fleet efficiency by flying more missions per plane; pilot hiring and training advancing, with early results expected in first half of 2026. | — |
| U.S. transplant modernization and OPO decertification | — | No disruption seen from HHS actions; management views modernization initiatives as a potential tailwind and opportunity rather than a risk, and is confident operating in current or future models. | — |