Core Insights - Sustained outperformance in MedTech requires structural demand drivers, improving execution, and clear earnings visibility rather than just short-term market rallies [2][6] - A select group of MedTech stocks, including TransMedics (TMDX), KORU Medical Systems (KRMD), and Cardinal Health (CAH), have significantly outperformed the S&P 500, which rose 19.3% over the past year [3][8] TransMedics (TMDX) - TMDX shares increased by 89.8% over the past year, driven by the adoption of its Organ Care System (OCS) and the expansion of its National OCS Program (NOP) [7][10] - The company reported revenues of $143.8 million in Q3 2025, reflecting a 32% year-over-year growth, with service revenues rising 35% [9][10] - The Zacks Consensus Estimate for 2026 sales is $723.8 million, indicating approximately 20.5% growth, with plans for European expansion [10][11] KORU Medical Systems (KRMD) - KRMD achieved a 45.5% stock growth over the past year, with Q3 2025 revenues of $10.4 million, marking a 27% year-over-year increase [13][15] - Core SCIg revenues grew about 30%, supported by international expansion and market share gains, despite a dip in U.S. revenues due to inventory adjustments [14][15] - The Zacks Consensus Estimate for 2026 sales is $49 million, implying 20.2% growth, with ongoing advancements in non-Ig drug collaborations [15][16] Cardinal Health (CAH) - CAH stock surged by 35.3% over the past year, with Q1 fiscal 2026 revenues of $64 billion, up 22% year-over-year, and earnings per share of $2.55, representing 36% growth [18][20] - The Pharmaceutical and Specialty Solutions segment led performance, with 23% revenue growth and 26% profit growth [19][20] - Management raised full-year fiscal 2026 earnings per share guidance to $9.65-$9.85, indicating 17-20% growth, while also returning $500 million to shareholders [20][21]

Core Thesis - TransMedics Group, Inc. (TMDX) is viewed positively due to its strong revenue growth, operational efficiencies, and potential for international expansion, despite a recent minor revenue miss leading to initial stock volatility [1][2][5]. Financial Performance - TMDX reported Q3 2025 revenue of $143.8 million, reflecting a 32% year-over-year growth, marking the 15th consecutive quarter of over 30% growth [2][3]. - The company experienced a significant increase in operating income, which surged nearly fivefold to $23.3 million, resulting in a 16.2% operating margin [3]. - Gross margins expanded by 290 basis points to 59%, driven by operational efficiencies and fleet optimization [3]. Market Expansion - International sales are currently modest at $3.6 million, but TMDX is preparing for expansion with the National Organ Care System Program set to launch in Italy in the first half of 2026, aiming for broader European engagement by FY27 [3][4]. - The upcoming Gen 3 Organ Care System platform and the 2027 launch of the kidney program are expected to significantly increase the addressable market [4]. Valuation and Investment Case - TMDX's forward revenue multiple stands at 6.8x, which is considerably lower than peers, indicating it may be undervalued relative to recent sector acquisitions [5]. - The company's operational momentum, expanding competitive moat, and multi-year growth visibility support a strong long-term investment case [5][6].

Core Insights - The article reflects on the importance of learning from past investment decisions, highlighting two stocks that have provided valuable lessons and solid returns [1][2] Group 1: Amazon Case Study - Amazon's Fire Phone was a significant misstep, leading to the decision to sell the stock despite its previous strong performance [3][4] - The stock, which had nearly tripled in value, ultimately became a 14-bagger, demonstrating the importance of long-term thinking and trust in management [4][6] - Key lessons learned include avoiding short-term thinking, trusting founder-led management, and not betting against innovation [6][7] Group 2: TransMedics Group Analysis - TransMedics Group, a provider of Organ Care Systems, was purchased at the beginning of 2023 and initially saw gains before a significant drop in share price following an acquisition announcement [9][10] - Despite initial concerns about the acquisition of Summit Aviation impacting margins, the company’s stock has since tripled from its lows, with sales more than doubling [12][14] - Recent financial performance includes a 32% increase in transplant revenue and a 35% rise in logistics revenue, with a net profit margin of 17% [16] - TransMedics aims to expand its transplant operations significantly and enter new markets, which could provide substantial growth opportunities [16][17]