TransMedics Group, Inc. (TMDX) Balance Sheet

The balance sheet has expanded rapidly, with total assets growing from $723.8M in 2024Q1 to $1.5B in 2026Q2, driven by a significant increase in debt and PPE. The D/E ratio, though elevated at 1.67 in 2026Q2, has improved from 3.24 in 2024Q1, suggesting that equity accumulation is partially offsetting leverage. This pattern implies management is aggressively investing in capacity, but the rising debt load warrants monitoring for refinancing risk.

Total debt nearly doubled from $469.7M in 2025Q4 to $867.7M in 2026Q2, while cash remained stable around $470M, indicating the new debt is financing fixed assets rather than liquidity. The D/E ratio of 1.67 is high relative to peers like Stevanato (0.32), but the company's strong current ratio of 6.62 provides a cushion. Investors should monitor whether the increased debt service burden aligns with cash flow generation, especially given the volatile operating margins.

The asset mix has shifted dramatically toward property, plant, and equipment, which now represents nearly half of total assets, reflecting a capital-intensive business model. Goodwill is minimal, suggesting growth has been organic rather than acquisition-driven, reducing impairment risk. The rapid PPE growth aligns with the surge in capex noted in the cash flow analysis, but the efficiency of these assets in generating revenue remains to be seen.

Equity has grown from $159.5M to $518.1M over the period, driven by a reduction in accumulated deficit, indicating that the company is generating profits and retaining them. No dividends or buybacks have been observed, consistent with a reinvestment strategy. The equity quality appears solid, though the negative retained earnings balance suggests a history of losses that are only now being offset.

Liquidity is robust, with a current ratio above 6.5 for the past ten quarters, indicating that current assets comfortably exceed current liabilities. Cash and equivalents of $472.7M represent a significant cushion relative to operating costs, though the company's cash burn from capex may reduce this buffer. The high current ratio suggests that short-term obligations are well covered, but the increasing debt load could pressure liquidity if cash flows deteriorate.