Q1 2022 Transmedics Group Inc Earnings Call
Percent MLP lung was 78% MLP and heart was 30% NLP.
As we move forward, we expect to see the percentage of revenue from MLP to continue to grow across all three Oregon platforms.
Importantly, this early momentum with MLP enabled us to repeatedly demonstrate our ability to facilitate more transplant volume at the central level.
With reduced operational.
Friction.
Of resources and logistics, while significantly shortening the typical sales cycle for Ocs technology.
Let me explain.
Historically via the direct acquisition model it used to take US 90 to 120 days to go from initial clinical buying.
To the issuance of the first purchase order of any transplant center wanting to adopt the ots.
From there it will take somewhere between 30% and 60 additional days waiting for installation and scheduling of training of their first team to be trained on how to operate those yes, and then once they're back it used to take somewhere between 15 and 30 days until we see the first true revenue generating case of this.
Transplant program.
With the MLP is the complete opposite.
We saw many centers in Q1 going live within few days literally few days from initial buying by the clinician clinical and administrative leadership until they did the first case in fact, the quickest was literally six hours.
From there once the center experience the simplicity of the MLP model they kept coming back for more cases.
Based on the above we see MLP as the most significant growth catalyst for not only our commercial growth as it drives efficiency and case volume incentive penetration, but also the overall U S transplant volumes starting in 2022.
In addition to MLP.
We also expect to benefit from two additional catalysts this year.
First is the recent FDA approval of our DCD heart indication.
Came in ahead of schedule.
This approval will allow us to expand into new centers that were not a part of the original DCD trial.
This will ultimately grow our ocs heart centers in the U S and drive case and revenue growth for the Ocs platform.
Second the expansion of the number of active Ocs center for each Oregon market.
Our goal is to end 2022, with 10 to 10 to 12 centers per Oregon lung heart and liver that are routinely using the ocs for their transplant as we've seen in the MLP centers in Q1.
Now, let's shift to provide you an update on our progress against our operational goals for 2022.
Goals related to the actual operations.
First our goal was to buttress, the MLP surgical and clinical staff, while expanding the MLP launching points for regions.
In Q1, we added two new surgeons, bringing our total head count to 10 full time surgeon supported by 12 contract surgeons in the MLP program.
We expect to add additional surgeon draw 2022.
We also increased our clinical support staff from 36 at the beginning of the year to 50 at the end of Q1 across the U S. All of whom are being cross trained for all three ocs platforms.
Finally, we expanded our MLP launch points or regions from 11 at the end of 'twenty one to 12 by the end of Q1 and as of today. We are at 14 active launch points in the United States, giving us broad geographical coverage.
The U S territory.
Second.
Operational goal is to expand our manufacturing infrastructure and capacity.
We are on track to expand our production capacity to accommodate anticipated mid and long term demand volume by year end of 2022.
This will further derisk our supply chain process.
The last operational goal was to invest in raw material inventory to meet the growing clinical demand.
We've invested in bolstering our raw material inventory to help us meet the clinical demand in Q1 with.
We plan to continue to make targeted strategic investments in raw material to minimize any negative impact of supply chain challenges on our business and our commercial execution throughout the year.
We're very proud of our commercial performance in Q1, 'twenty two and we are focused on maintaining this level of execution throughout the year.
Despite the potential impact from macro headwinds.
Let's discuss these potential headwinds.
The lung transplant volume remained somewhat vulnerable to further COVID-19 waves as they were in early Q1.
Although we've seen minimal or no impact from Amit <unk> from heart and liver transplant volume.
The second potential headwind.
As we remain exposed to ongoing global supply chain challenges.
While we have largely largely mitigated the impact to our revenue to date, our early rapid clinical adoption has meaningfully increased the rate of inventory usage.
Despite our investments. This is an area that we cannot always control and may negatively impact us in 2002.
Nonetheless give.
Given the growing demand for the Ocs technology.
Our strong Q1 results and the other key catalysts that.
Just reviewed.
We are increasingly confident in our near mid and long term outlook.
However, we need to remain prudent in our expectations given the global potential headwinds mentioned above.
As such we are raising our annual revenue guidance for the full year 22 to <unk> 59 to a range between 59% and $65 million. This represents a solid 95% to 115% growth over 21.
This compares to our previous guidance.
A range between 49% and 55 million.
Before turning the call over to Stephen I would like to provide summary highlights from last week's annual meeting of the International Society of heart and lung transplantation or <unk> that took place here in Boston.
We're long term results of Ocs heart and lung trials were presented.
Specifically the results of the U S randomized Ocs DCD heart trial was presented by our lead investigator.
The data showed that the use of Ocs heart technology resulted in high rate of 88, 9% successful utilization of DCD donor Hearts for transplantation.
And importantly, with excellent post transplant clinical results that.
The trial reported one and two year survival results of 93% in the DCD Ocs arm, both at one year and two years compared to 86% and 83% respectively. In the DVD control arm of standard criteria heart transplanted using cold storage.
These similar results are going to be instrumental in significantly expanding the utilization of DCD donor hearts for transplantation in the U S. Thus, providing access to more patients with heart failure to receive their life saving heart transplant procedure.
From the lung front, the five year Ocs lung expand trial results were also presented by the lead investigator.
The results showed that the use of ocs lung and extended criteria DVD and DCD donor lungs resulted in a five year survival of 68% compared to the U S national average or the U S.
Five year lung transplant outcome of 59% from routine.
Lung transplantation based on the units for Btn National data.
This is clinically powerful to show that we can expand the lung transplant volume in the U S from extended criteria lungs, and have good post transplant clinical outcomes that compares favorably to routine lung transplant outcomes.
In the U S.
With that I will now turn the call over to Steven.
Thank you Ali and I will now provide some additional detail on the Q1 results.
Other financial information for the quarter.
For the first quarter of 2022, our net revenue was $15 9 million.
This was an increase of 125% from the first quarter of 2021.
The sequential increase of 64% from last quarter.
In the U S. Net revenue was $13 6 million a 136% growth over the first quarter of 2020 was.
The Oregon breakdown is as follows in the U S. Net revenue was $7 9 million an ocs liver.
$3 7 million, and Ocs heart and $2 million of Ocs lung.
Revenue outside the U S was $2 3 million, that's up 79% from Q1 2021 and included $2 million of Ocs Heart and <unk> 3 million Loews feel slow.
Key driver of Q1 revenue performance was the acceleration of Ocs liver and Ocs heart utilization after the recent FDA PMA approvals in 2021.
We began the commercial launch of these products in Q4, 2021, but really saw the impact, especially of Ocs liver sales in this first quarter of 2022.
In addition, the positive impact of our National Ocs program was apparent in these results with 98% of our liver cells involved industrial program cases.
Gross margin for the first quarter of 2022 was 76% that's up from 68% in the first quarter of 2021.
<unk> improved from 72% reported in Q4 2021.
The higher gross margin as a result of the higher revenue and fully commercial revenue in the United States.
Total operating expenses were $21 5 million in Q1, 2020 to a 90% increase over Q1 of four wall operating expenses.
The significant increasingly expenses was primarily driven by the growth in our commercialization effort in the U S.
<unk> in particular.
This represents our continued investment in our regional resources and infrastructure to allow us to access more national program Transplantations across all orders in all regions.
We also saw significant growth in R&D expense as we made important progress on our next generation Lcs.
Program.
However, while national program spending will continue to grow this R&D investment in Q1 2022.
Included some nonrecurring project costs and I expect next quarter's R&D spend to be more in line with what we saw in Q4.
Our operating loss was $9 4 million in the first quarter of 2022 compared to $6 5 million for the first quarter of 2021, and our net loss for the first quarter of 2022 was $10 6 million compared to $7 9 million in the first quarter of 2021.
Finally cash cash equivalents in marketable securities were $72 million.
As of March 31, 2022, which equates to a reduction of $20 5 million from the balance at the end of Q4 2021.
This cash burn rate was higher than typical and was reflective of the timing of several large impacts of items in the quarter. The most significant area in both their touch was our investment related to inventory and capacity ensuring that we are prepared for significant growth in 2022.
We also saw the non recurring investments in next Gen platform that I mentioned earlier.
Growth in the National program as well as other working capital related uses of cash looking forward I do expect our cash burn to be at a more typical run rate of approximately $10 million to $11 million per quarter.
Our weighted average common shares outstanding for the quarter were 20 795 million shares.
And as a result of our strong commercial startup as Rajeev mentioned, we are raising our annual revenue guidance to <unk> $59 million to $65 million for the fiscal year of 2022, which represents 95% to 115% growth over 2021.
I would say I would like to turn the call back to our lead for closing comments.
Thank you Steven.
In summary, we're proud of our Q1 commercial performance.
However, we don't plan to stop here or be satisfied with that.
We are now focused on driving continued growth through throughout 2022 and beyond.
That national Ocs program NLP has shown its potential to drive significant growth for <unk>.
So driving clinical efficiency and adoption by transplant centers in the U S.
The addition of the FDA DCD heart approval uniquely positions <unk> as the trusted partner to any U S heart transplant program interested in growing their volumes from DCD heart transplants.
We look forward to maintaining our momentum as we continue to leverage all three ocs platforms to deliver more and better organs for transplantation to those patients in need.
With that I will now turn the call to the operator for Q&A operator.
And Lee if you would like to ask a question. Please press star followed by one on your telephone keypad. If for any reason you think turn lift that question. Please press star followed by tier again to ask a question Press Star one as a reminder, if you are using a speakerphone. Please remember to pick up your handset before asking a question.
The first question is from the line of.
<unk> <unk> with Canaccord. Please proceed.
Yeah, great. Thanks, good evening.
A couple of questions for me here I think the first is really around guidance and.
Maybe I'll step back in the quarter extremely strong quarter can you <unk>.
Looking at the quarter it.
$15 9 million Annualizing that gets us to $64 million, which is the.
Towards the higher end of that guidance I'm just.
Trying to understand like was there stocking in the quarter is there a certainty of play systems, especially as a lot of this is MLP I'm just trying to get my head around kind of.
The guidance for flat sequential quarters based on the guidance.
Does that is there.
Bill or there is another question. That's my first question. That's my first okay, great. So.
Thank you for the question, it's an important question so.
I want to clarify one thing.
We.
Our guidance reflect exactly what we discussed on the call.
As we have to be prudent we only have two full commercial.
Quarters under our belt.
We're just getting started.
There are macro headwinds that could.
If any of them.
<unk> activate it could.
Dramatically impact.
Our ability to execute.
The MLP in it of itself, we're ramping up resources, we're adding new people.
And we need to be prudent we need to not to get too far.
Lean forward off our skips, we need to stay the lane and we think this is a significant growth and we would rather be prudent and b.
Cautious in our.
Building, our commercial credibility.
And we will reassess as we see Q2 and Q3 results. So that's that's really what's driving that bill it has nothing to do with stocking orders.
In fact this is why.
Specifically commented on.
The Q1 revenue came from this is primarily MLP guys. There's no stocking order here and with MLP. Every case is revenue every revenue is a case and then there is another case that would generate another another revenue.
Okay. Thanks, and then my second quarter shifts I think obviously liver far exceeded expectations. So I was wondering if you could just give us a little idea on the dynamics of why liver would have such a quick uptake with MLP and.
Look at the U S hired it was.
Flattish sequentially, which was a bit surprising and maybe why we didn't see it there and I know, we just got the DCD data.
Which was extremely positive, but just any color could could help us out there. Thanks.
Maybe on the end of that is is they're not sustainability of repeat ability with the MLP and maybe is that why there is some conservatism.
People used it and then held off or is there something youre seeing that we should be aware of thanks sure. Thank you Bill so very important question.
So liver, we expected livers can lead the way, we've been saying that throughout our public interactions throughout <unk>.
End of last quarter and this quarter why for two important reasons as I said liver volumes liver transplant volumes are nearly double the heart and lung transplant volumes combined in the United States.
That sheer number.
<unk> is very important and that's.
That's one reason the second reason is because that high volume.
Transplant liver transplant programs in this country are very.
Used to having somebody else.
Procured deliver for them.
<unk>.
Shipping it to them there.
We're also focusing on how can be do more liver procedures with the limited staff behalf here comes the MLP to solve both problems we can.
Provide them confidence that we can ship delivers to them.
Supported by our clinical staff that Babysits. These liver for them until they are ready to do the procedure with their staff being at home base rested and in many cases.
Schedule scheduling the liver transplant procedure in the morning, So that's why.
<unk> transplantation.
We expected it to lead the way and we expect it to continue to do that because of these two reasons that being said, we expect to see the heart and lung to pick up pick up the pace throughout 'twenty two.
The MLP is.
Barring any quality issue.
MLP is one of the most repeatable sustainable model for driving revenue in <unk>.
<unk> history.
But we need to meet again Bill is no there's no hidden messages.
US being proven being conservative to make sure that we earn our stripes. After as we as we see that the results come in Q2 and Q3, we will reevaluate.
Items from there, but at this point, we felt that this is.
This guidance represents significant growth and we want to continue to put points on the board.
But theres no hidden messages or negative messages that we are concerned about MLP is is a solid generator of it.
Repeatable cases and expanding.
We haven't talked about one of the major value for the Ocs for the MLP as you've heard me say at the ice Trophy is minimum nation of the learning curves and you've seen and heard many centers are very very excited about this so we expect to see MLP to continue to deliver significant.
Contribution to our revenue throughout 'twenty, two the guidance is merely us being conservative.
Thanks for taking my questions.
Thank you Mr <unk>.
The next question is from the line of selling yesterday, along with Morgan Stanley . Please proceed.
Great. Thank you for taking my question and congrats on a great quarter.
We just decided again really on your outlook for 'twenty, two but then breaking it down into pieces and just how youre thinking about MLP contributions really restarting we accelerating loan volumes on the on the heels of Covid. It's really as you think about just exiting the year.
And then focus on some of the higher volume centers, how do you think about just the breakdown.
Keith basis contribution exiting the year versus what we saw in the first quarter.
Thank you Cecilia.
So as far as the first part is how.
How do we think about the cadence kind of exiting the year.
I think when we start the year with 70% blended mix. If you remember on the last call we were hoping to end the year with 30%.
MLP contribution so what we expect to see as we at least maintain 70% or even higher.
NOP cases exiting the year.
As Ive stated through the second part of your question about the contribution of NOP to recover in the lung commercialization.
Commercialization effort in expanding the heart. This is exactly why we did the MLP to Syria, and we are confident that the MLP will play a key role that once the COVID-19.
Issue kind of settles down the MLP will be there to pick up the lung and accelerate the lung contribution to our overall growth going forward and we expect to see that for the heart I think the community. We are waiting for the DCD approval that presence.
Our presence at the IAC Trophy.
There was a palpable broad palpable buzz around the Ocs heart and lung and MLP when people would stop me in the floor of the of the conference and talked to me about MLP with literally MLP acronym.
Very exciting so we.
We are focused on making sure that we end the year with a very large contribution of our revenue. The vast majority of our revenue to be MLP, we expect the MLP to help the lung recover and help expand.
The heart volume as well as <unk>.
Help continue to drive liver adoption across more centers.
Sure.
And that and that's the beauty of MLP. We have we have we have to make sure. We continue to beef up the staffing and the surgical expertise, but that's something that we are committed to doing anyway.
Okay, and if I could follow up specifically on Hyatt.
And just kind of thing.
Cutting plastic surgeon maybe dean.
Little less.
Kind of.
Going to adopt versus liver transplant, but just as you think about the volume flowing to MLP going forward. It's all at the next really between.
DCD DVD I'd love to hear just longer term outlook. If you think about both of those.
Sorry, if this thing for then thank you.
Thank you.
I think.
I think the.
We.
We are.
We're very familiar with the mindset of the cardio thoracic youth.
Users of Ocs.
And we we believe that we.
We will be best positioned to turn that into.
Successful adoption and utilization of our Ocs platform in both DVD and BCD.
And predominantly through the MLP.
Let me repeat again, a point I made to Bill's earlier question one of the key elements of MLP that we played.
We.
Pointed heavily at the IAC choppy.
You have now every Tom <expletive> and Harry Heart transplant program wanting to do DCD heart transplants or extend into DVD heart transplant using those yes. The learning curves that would have been associated with that expansion would have been huge and it could have actually negatively impacted the rate.
Adoption of Ocs now, having the MLP will will buffer against that and what we are witnessing Cecilia is the transplant surgeons themselves are welcoming this MLP to minimize their learning curve because they know that their outcomes are important and they are looking for us to best manage these organs.
For them on the Ocs technology. So we are confident that.
Part will be utilized for DVD and DCD and we expect the mix to be.
60 40 or.
50 50.
And at least Thats throughout 2000 22022.
Okay. Thank you for taking the questions.
Thank you Ms furlong.
The next question is from the line of Josh Jennings Cowen. Please proceed.
Hi, good evening, thanks for taking the questions.
Great to see such a strong start to the year I wanted to ask related to Stephen I'm, just you talked about the buzz from the heart transplant surgery.
<unk>.
Posted DCD data.
I think you expressed before the low hanging fruit on Linda.
Linda <unk> data release would be just increased interest in centers that hadn't participated in either part.
Any of our trials can you just build on that just on the buzz for one.
Two how does that it could catalyze more non trial centers to adopt ocs and maybe even adopted the MLP.
<unk>.
And then lastly.
Do you think that the <unk>.
Non non trial centers will accelerate MLP adoption.
DCD Heart DCD heart.
Thank you Josh.
So let me let me clarify one point the buzz that was generated at the ISC <unk> was on heart was actually multifactorial buzzword across heart and lung and for the heart specifically it wasn't just about the DCD data or the DCD approval, but also the long term results.
The expand.
DVD extended criteria Hearts, which a lot of people.
Came to this meeting anxiously waiting to see the results because that was the first of its type trial. If you remember Josh so the buzz is multifactorial.
All three elements DCD MLP and the DVD heart.
The pieces of the story contributes to that bus.
Wow.
Do we expect many non trial centers to jump and tried to do DCD heart absolutely.
Absolutely I think the primary driver for any heart transplant program today in this country is to do DTD and expand their volume because they know that CMS is going to be coming looking at their transplant volumes very soon.
We expect that to happen now the MLP will become the catalyst for the facilitator because with the MLP.
It streamline the process.
It also protects them from the learning curves. It also protects them from the.
Resource constraints that each transplant program is operating under.
And it makes it gives them a much better leverage on controlling their schedule a lot of site conversation of dice entropy, where between some of our users and some of the new centers talking to each other about now that they can schedule the heart <unk> lung transplant procedure to be an early morning procedure rather than the mid.
All of the night.
And this.
This confidence is afforded to them by the Ocs and.
You can see that you can see the excitement of moment.
It's early days and this is why we have to be prudent and we have to continue to watch this dynamic, but we believe wholeheartedly that the MLP will be the largest catalyst to increasing the number of.
Transplant centers that are using the ocs, increasing the volume of successful transplant, a decent situtions and.
Secondarily, increasing the overall transplant volume in the United States.
Excellent well thank you for that.
Highlighting this wasn't just the hard line policies for the leading question.
And.
Just.
Just piggybacking off that answer will lead and just thinking about this data and how it could impact.
And I am focusing on the hardware.
I understand alone one data was very strong as well and powerful but just focusing on part of just because you've had the strongest O U S.
Utilization of Rcs in the heart indication, but what is the state of do further for the <unk> Rev.
Our revenue growth.
Thank goodness have you gotten feedback from international heart transplant surgeons already and how do you see that absolutely.
Absolutely absolutely we hosted our annual users.
Dinner at <unk>, which was the highest number of.
Guests, we've ever had at nearly 180 guests many of whom were international users. So the see the momentum the see the data.
And we expect that momentum to pick up however, international revenue is always going to be plagued with the lack of reimbursement until we secured national reimbursement at each of these geography that being said I have to also highlight one positive.
Outcome that came out from one of the least geographies that we expected.
Presentative of the UK.
Transplant community.
NHS representative came to us and wanting invited us to go and negotiate or discuss seriously with NHS.
The profitability of replicating the MLP in the UK transplant community. So again. This is this is.
Some.
Secondary.
Positive.
Momentum from highlighting the MLP or exposing the MLP, but publicly and we expect to continue to see that we've already seen.
Countries like the Netherlands trying to implement the MLP.
With DCD Hearts and successfully sold throughout 2021.
So we're excited about where we are Josh we're excited about where this is going.
Our goal is to just to continue to be.
A steady hand and.
Focusing on the fundamentals and making sure that we were.
We're continuing to drive positive change and positive momentum.
Focusing on maintaining the highest quality results.
I hope that makes sense.
Yes that was very helpful. Thanks for your answers.
Thank you Mr Jennings.
The next question is from the line of Allen Gong with Jpmorgan. Please proceed.
Hey, guys.
Gratulation is on a really great start to the year I just had a few quick ones.
Looking at the performance you had in the quarter and looking at your original guidance spread apart from your omicron, maybe being a little bit less of a headwind than you might have contemplated initially what you said already it wasn't really a challenge to heart and liver, what really ended up being so much better than expected was it just much faster adoption of the <unk>.
Was there anything else that really drove this kind of outsized performance relative to your own expectations.
That's it.
So very rapid adoption of MLP.
And.
And combined with the sheer volume of liver cases really these are the two combination.
That led to the quarter being what it is.
In fact.
To a smaller extent.
Omicron in Q1 early Q1 in January may have even negatively impacted the lung worse, if the MLP wasn't there because it helped recovery through February and March So really it's a combination of the MLP and the sheer number of liver transplant cases.
That as I said it is nearly double the heart and lung combined.
Stephen do you see it differently.
Yes, Thanks, Ravi Thanks, Elena I would disagree it's really the acceleration of the liver in particular, especially with some pretty large liver centers.
We're able to do a lot of cases in the.
Very short amount of time, so once that.
<unk> MLP and realized that it was going to work for them.
To use it throughout the quarter and that was a little bit above expectations I would say for Q1.
Actually Alan if you allow me to kind of add one.
<unk> point to what Steven just said.
Give you one example, anecdotes from the quarter.
The largest liver transplant center in the United States.
It belongs to one major health.
System that is headquartered in Rochester, Minnesota has never used the ocs in the trial or any of our trials for liver or heart or lungs.
They became one of the highest users of ocs liver MLP.
Became.
<unk>.
In Q1, they are now scheduling their liver transplant procedures, they're staggering liver transplant procedures. Many nights, we have two levers on the ots.
Two different <unk> coming from two different parts of the country through NLP and Theyre staggering them. So they can do them first thing in the morning.
And the likes so this is kind of a positive impact.
We want to build on these anecdotes and increase them and expand them.
Another anecdote is one of the key centers in that and some of the competing technology trials they became again.
Ever touch the Ocs maybe.
They became one of the major users of the technology.
Yes that liver technology in the MLP in Q1, and we expect them to grow with us throughout 2022.
Got it and then just one quick one following up on a question that was asked earlier on long right is <unk>.
<unk> has clearly been a very big challenge to long and it's why.
It was the first Oregon, you've really had one that's been on the MLP. The longest has continued to struggle but.
It's hard to say when the pandemic will officially and so like what.
Should we be looking out for to really showcase that like trends are really turning around a guideline is starting to change and really do enable you to get one up and started in ramping to the same extent as liver and heart. Thank you very much.
Thanks, Alan that's a very important question so Alan.
I don't believe you had the time to attend <unk> peak, but we announced a major national initiative at <unk>.
Calling out.
Doubling the heart and lung transplant volumes in the U S over the next few years.
We had.
Early positive response from leading lung transplant programs large academic lung transplant programs in this country and we are organizing that movement and we expect that by the end of 'twenty to Q4, 'twenty two we will see tangible.
Growth in the lung volume on Ocs predominantly through the MLP.
So we are tracking the lung we are not giving up on the lung. The opposite is true we think that the long future is bright the MLP will help the lung recover faster and we would be there hopefully by the end of this year pointing out to some tangible evidence of how the lung is recovering nicely.
The U S.
Operator should we move to next.
Question.
Thank you Mr. Zhang.
Next question is from the line of Mike <unk> with Oppenheimer. Please proceed.
Good afternoon, while even Steven Im on for Suraj Tonight, Congrats on the strong start to the year and thanks for taking our questions first one on the DCD heart data last week was the greater proportion of moderate and severe primary graft dysfunction in Ocs group versus the control I think 20% versus about $9 one just yet.
Ocs had sicker patients and yet achieved the better survival we saw.
Thank you Michael.
The numbers were about 17% versus about 10%.
Actually.
15% versus 10%.
The <unk> and DCD heart transplant has always been reported to be higher than the BD heart transplant. The remember these are not normal hearts. These are heart that cease to function the stop beating.
Clinically dead Hearts subjected to warm ischemic injury in the body of the donor until they were.
Procured.
And instrumented and Ocs.
That being said that whatever early hit that they took were recovered by ocs and resulted in excellent post transplant outcome and the <unk> that we saw in DCD heart transplant.
Didn't translate into survival outcome and Thats not just in our randomized controlled trial.
The data that was published from single center and Multicenter cohorts from the U K and Australia showed exactly the same numbers in fact, the early data from Australia had a <unk> rate of 40%, 45% yet the long term survival outcome mirrored what we've experienced here in the U S randomized trials.
And I think this.
At this point the specific point was discussed Michael at when that data was presented and there seems to be a clear consensus clinical consensus that.
PGD and DCD means something different and it's not the PGD that we experience with DVD heart transplants that has correlation to short and long term survival and we will continue to look into this particular question throughout our post market performance and.
It's exciting it's exciting times and.
The field is being transformed.
Thanks to transmit X technology, and NLP programs, and we plan to continue to collect post market evidence and data to address all these important questions going forward and hopefully that would translate into.
Clinical guidance updates and practice updates and the likes.
Okay. Thanks, that's helpful and detailed explanation Lloyd and then any rough estimates as to how many incremental DCD hearts could ultimately be transplanted here.
The U S. One in 2000.
The estimates you could share at this stage.
I mean, I can I mean that is a very difficult question to answer for the following reasons.
And at that point was also kind of discussed on the side discussions after the data was presented.
There is a significant under reporting of DCD donors and this country because they were used only for kidney for kidney and a little bit of liver. So.
And so it's very difficult to estimate but based on the 2021 data. There was 3000 DCD donors that donated a single Oregon in 2021 in the United States that cohort the DCD donor cohort.
They are the highest rate of increase year over year at approximately 30% ending the year of the of all the donor rate deceased donors and then as states.
Even if you cut that in half, Mike and you apply that 89% utilization rate you can meaningfully expand the heart transplant volume.
In the United States from the DCD donors, but we expect that we're not going to stop there that they will be more and more opportunities for BCD numbers to grow given that now we can utilize their organs across heart lung liver and obviously the historical kidney so <unk>.
<unk> contribution is going to be huge DVD contribution is going to be even bigger because when you look at DVD. We know for a fact that we have 8000 or <unk> 8500 Hearts that are that go unutilized every year and with the Ocs. We've demonstrated that we can transplant, 85% of those hearts that were placed in ocs so that.
The combination of both is what gives us a very high degree of confidence that we can double the rate of heart and lung transplantation in the U S. Just using DVD Oregon's every year, the DCD will be icing on the cake.
Great. Thank you so much for answering our questions.
Okay.
Thank you Mr.
There are no additional questions waiting at this time, so I will now turn the call over to Ali for closing remarks.
Thank you operator, thank you all very much for taking the time to be on our call and we're looking forward to speaking again.
After Q2 results. Thank you have a great evening.
That concludes today's call. Thank you for your participation you may now disconnect your lines.
Oh.