Good afternoon, and welcome to TransMedics' Second Quarter 2022 Earnings Conference Call. At this time, all participants are in a listen-only mode. We will be facilitating a question and answer session towards the end of today's call. As a reminder, this call is being recorded for replay purposes. I would now like to turn the call over to Brian Johnston from the Gilmartin Group for a few introductory comments. Thanks, operator. Earlier, TransMedics released financial results for the quarter ended June 30, 2022. A copy of the press release is available on the company's website. Before we begin, I would like to remind you that management will make statements during this call that include forward-looking statements within the meaning of federal securities laws, which are made pursuant to the Safe Harbor provisions of the Private Securities Litigation Reform Act of 1995. Any statements contained in this call that relate to expectations or predictions of future events, results, or performance are forward-looking statements. 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, regulatory approvals and reimbursement, and guidance and/or expectations for revenue, gross margins, and operating expenses in 2022 are based upon our current estimates and various assumptions. 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. For a list and description of the risks and uncertainties associated with our business, please refer to the Risk Factors Section of our quarterly report on Form 10-Q filed with the Securities and Exchange Commission on May 5, 2022. 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, August 1, 2022. With that, I'll now turn the call over to Waleed Hassanein, President and Chief Executive Officer. Thank you, Brian. Good afternoon, everyone, and welcome to TransMedics' second quarter 2022 earnings call. As always, joining me today is Stephen Gordon, our Chief Financial Officer. Before discussing Q2 results, let me first briefly highlight our $60 million debt financing agreement with CIBC Innovation Banking, which was announced earlier today. The new facility, which was fully funded upon closing, enabled us to retire our previous debt arrangement with OrbiMed and strengthen our balance sheet to provide further financial flexibility. We greatly appreciate the partnership we have with OrbiMed and very much look forward to establishing a successful partnership with CIBC in the years to come. Now let me shift to our exciting Q2 results. Through the second quarter, our commercial momentum accelerated, with results delivering an unequivocal statement on TransMedics' growth potential and our commercial execution post-FDA approvals of our OCS technology for three large transplant markets. Importantly, our performance in Q2 underscores the importance of NOP, or the National OCS Program, as the main growth driver for our business in the United States. Let me summarize the results. For the third sequential quarter, we posted a record year-over-year growth in net revenue. Net revenue for Q2 was $20.5 million, representing 151% growth over the same period of Q2 2021, and approximately 29% sequential growth from Q1 2022. Importantly, 88% or $18.1 million of Q2 revenue came from the U.S. centers. This represents 215% growth over the same period from 2021. NOP-attributed revenue accounted for approximately 84% of our total U.S. revenue in Q2 2022. We fully expect that NOP will remain the main driver for our U.S. business for the foreseeable future. Stephen will cover the details and organ split in his section of the call. Now let me discuss some other trends that make us confident in our near and long-term growth potential. First, for the second sequential quarter, liver led the way across our three organ markets. This is indicative of our ability to quickly scale operations and build momentum in the largest of our three addressable markets. We were also excited to see that liver centers have become quickly accustomed to the NOP concept. Second, heart and lung also continued to grow sequentially despite overall U.S. lung transplant volumes remaining below pre-COVID rates and a slower-than-normal June in the U.S. across organs. This slowdown was reflected in the U.S. national OPTN reports and is relatively normal phenomena in transplantation. As is the rebound in rates in July, which we also experienced. Third, as we highlighted earlier, NOP drove a significant portion of our U.S. revenues in the second quarter, validating our expectations that it will become and will continue to do so for the foreseeable future. As I had stated earlier, 84% of our total U.S. revenue came from NOP. On the per-organ basis, liver was approximately 99% NOP, lung was approximately 93% NOP, and heart was approximately 57% NOP. As we move forward, we expect to see the percentage of NOP continue to be high and grow across the board, especially for heart transplant numbers. Notably, given the high contribution of NOP, our revenue represented impressive growth in actual new cases and not just stocking orders. This is one of the most interesting and important features of NOP as it makes our business more linear in terms of revenue growth as we further penetrate transplant programs. Further, it is important to note that 2Q results came from a fairly modest number of transplant centers between 6-12 in each organ category. This is important for two reasons. It shows that we have a significant greenfield opportunity for commercial growth from adding more U.S. transplant programs or centers to use our NOP program. This is a critical area of our growth strategy that I will be touching upon later. Second, it shows that the continued deeper penetration of OCS within these initial number of centers who are relying on us to operate their transplant programs. This is huge from a competitive positioning standpoint. TransMedics NOP is becoming an integral part of many U.S. transplant programs' workflow. Lastly, we had a very successful 2022 ISHLT conference in Boston in April. This was the first live meeting since COVID, and we were very encouraged to see TransMedics OCS and NOP as the clear focus of this meeting. There were several featured presentations on OCS Heart DCD and EXPAND results, long-term outcomes of OCS Lung INSPIRE and EXPAND results, and the first public presentation of the NOP program's concept. Importantly, we took this opportunity to publicly launch an aspirational U.S. initiative to doubling lung and heart transplant numbers over the next five years using the TransMedics NOP program. In all, we were very encouraged by several trends through Q2 and believe we have positioned TransMedics to achieve 100% year-over-year revenue growth in 2022. Now let me discuss our strategies to deliver on this expectation and to extend our momentum into 2023 and beyond. First, by expanding our NOP infrastructure. This is critical and will include increasing the number of surgical staff, especially on the liver side, expanding the number of launch points to gain broader geographical coverage in the U.S., and growing our clinical support staff. Importantly, we need to grow our transportation and logistical network to drive efficiency in execution and financial performance. Second, by expanding our manufacturing and production capacity. We are well underway to tripling our production clean room infrastructure by year-end, enabling us to meet the significant demand of OCS use across all three organ platforms. We are also expanding our production headcount and instituting a second shift. In addition, we're continuing to buttress our raw material inventory to meet the growing demand and to mitigate against supply chain risks. Third, by expanding the number of active NOP transplant program in all three organ markets. We have seen the significant impact from a modest number of active transplant programs in the U.S. on U.S. revenue over the past three quarters. We are planning to methodically grow our number of active NOP programs in the U.S. throughout 2022 and into 2023 and beyond. Finally, by continuing to invest in our next generation OCS technology and our next organ programs. This is critical to our long-term growth and future and further distancing ourselves from any potential competition. In our view, the roadmap forward is clear, and we believe strongly that we are operationally well prepared to take these critical next steps. However, while we believe we are in the early stages of rapid growth trajectory, we also see the current macro environment and rapid increase in demand for our OCS technology could present some challenges that may create some level of bumpiness in our business. For clarity, let me provide some perspectives on what we view as potential uncertainties that may negatively impact us in the second half of 2022. These are the main reasons for us being prudent and cautious in our expectations throughout 2022. First is the global supply chain issues during the scalability of our production capacity to meet the growing demand for our OCS technology. 2Q results continued to outpace our forecasted demand plans and challenged our finished goods inventory. Our operations and supply chain team has been doing a phenomenal job to mitigate the risks of any backorder situation. We remain cautious, however, because we are concerned that our continued investment to rapidly increase our raw material may be negatively impacted by some unforeseen supply chain issue from one of our vendors or suppliers. The second is the scaling up NOP infrastructure. The time to recruit, train, and certify clinical staff to be able to be fully functional in the field presents a potential time lag while we are rapidly growing our case volume. We are instituting several initiatives to standardize our clinical training programs for our field team, as well as continuing our recruitment efforts throughout the United States. Third is the access to charter air transport to maximize coverage and availability. This is an important area as we are seeing the global conditions limit the availability of chartered flights used for organ transplant support in the U.S. We are actively expanding our network and will aggressively pursue new strategies to minimize this risk on our long-term growth potential. Third is the impact. Oh, I'm sorry. Fourth is the impact of summer vacations and end-of-year holidays on second half 2022 revenue. It is the norm that August is a fairly slow month for our international transplant activities, given the impact of summer vacations in Europe. Q4 will also have the impact of Thanksgiving and Christmas holidays, which may negatively impact transplant volumes in the United States. Finally, COVID. We see minimal or no impact of COVID on heart and liver transplant trends. However, as we stated before, lung will always be disproportionately impacted by any new COVID waves or variants. Based on our Q2 and H1 results and balancing these great results with the above potential growing headwinds. For the second sequential quarter, we are raising our annual revenue guidance for the full year 2022 to between $67 million-$75 million, up from $59 million-$65 million for the same period. This represents a solid 121%-148% growth over 2021. We take guidance very seriously, and we wanted to make sure that we are being prudent and reflecting the realities of the potential growing pains. With that, let me turn the call to Stephen to cover the detailed financial results for the quarter. Thank you, Waleed. I will now provide some additional detail on the second quarter results and other financial information for the quarter. For the second quarter of 2022, our net revenue was $20.5 million. This is an increase of 151% from the second quarter of 2021, and a sequential increase of 29% from last quarter. In the U.S., net revenue was $18.1 million or 215% growth over the second quarter of 2021. The organ breakdown is as follows on U.S. net revenue, was $9.6 million of OCS Liver, $5.9 million of OCS Heart, and $2.6 million of OCS Lung. I'll repeat those numbers again, for the folks listening. $9.6 million of OCS Liver, $5.9 million of OCS Heart, and $2.6 million of OCS Lung. All organ products grew sequentially from the first quarter of 2022. Outside of the U.S., our revenue grew 9% on a constant currency basis. However, taking into consideration unfavorable currency movement, reported revenue was $2.4 million, down 1% from Q2 of 2021, and included $2.2 million of OCS Heart and $0.2 million of OCS Lung. The key driver of Q2 revenue performance was further utilization of the OCS across all organs. In particular, our National OCS Program continues to be the critical commercial vehicle for further customer adoption in the U.S. Gross margin for the second quarter of 2022 was 70%. That's up from 68% in the second quarter of 2021 and down sequentially from 76% reported in Q1 2022. The improvement in gross margin from Q2 of 2021 is a result of the higher revenue and fully commercial revenue in the U.S. The sequential reduction in gross margin is a result of the higher mix of NOP-related revenue. We expect gross margin to improve in the future as we move out of the early phase of the NOP and improve its efficiency. Total operating expenses were $24.1 million in Q2 2022, a 56% increase over Q2 2021 operating expenses. The significant increase in expenses was again driven by the growth in our commercialization effort in the U.S. and our NOP in particular. This represents our continued investment in our regional resources and infrastructure to allow us to access more national program transplant cases across all organs and all regions. We also saw growth in R&D, primarily related to development of our next generation OCS. However, as we described last quarter, R&D spending was sequentially lower in Q2, 2022 due to less next gen development activity this quarter compared to last quarter. Operating loss was $9.7 million in the first quarter of 2022, compared to $9.9 million in the second quarter of 2021. Our net loss for the quarter of 2022 was $11.5 million, compared to $10.7 million in the second quarter of 2021. Cash, cash equivalents, and marketable securities were $58.1 million as of June 30, 2022, which equates to a reduction of $13.9 million from the balance at the end of Q1 2022. Weighted average common shares outstanding for the quarter were 27.98 million shares. Finally, as Waleed mentioned earlier, we took an important step to provide additional financial flexibility in July 2022 by refinancing our existing debt with a new $60 million term loan with CIBC Innovation Banking. A portion of the new loan was used to pay off the balance of our prior loan with OrbiMed, and the new loan added approximately $23 million of new cash to our balance sheet. As I usually do before returning the call to Waleed, I will just reconfirm the increase in our revenue guidance for 2022 is $67 million-$75 million for the fiscal year, and this represents a range of 121%-148% growth over 2021. Now, I would like to turn the call back to Waleed for closing comments. Thank you, Stephen. In summary, we're very pleased with our 2Q performance. The TransMedics NOP integrated approach has clearly proved its unique ability to streamline the transplant process for transplant centers and drive significant growth. Our demonstrated ability to execute on rapidly scaling the NOP to include liver and hearts over the past two quarters and launching new initiatives leaves us more confident than ever in our ability to continue to drive significant commercial growth throughout 2022 and beyond. As we stated before, we believe we are still fairly early on our growth trajectory, and we are laser-focused on continuing to build on our commercial momentum for the future. We are inspired and excited for the future of TransMedics as we continue to transform the global organ transplant across geographies and cement our global leading position in transplant therapy. With that, I will now turn the call to the operator for Q&A. Operator? Thank you. If you would like to ask a question, please press star followed by one on your telephone keypad. If for any reason you would like to remove that question, please press star followed by two. 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 your question. We will pause here briefly as questions are registered. Our first question comes from the line of Bill Plovanic with Canaccord. You may proceed. Great. Thanks. Good evening. Couple questions. First, on guidance, and obligatory, I have to ask this, but you're $67-$75 million. You did $36 million in the first half. You know, the range would be about $30.5-$38.5 million in the second half of the year, which would contemplate down in the second half versus first. How many of these issues that you said are potential headwinds are you seeing or experiencing today, or is it more of a concern? I'm just trying to understand what's embedded in that range. Thank you, Bill. The guidance we're giving is the guidance we stand by. The rapid growth and acceleration in utilizing our finished goods inventory have really put a lot of challenges in our ability to continue to beef up that inventory. That is something we're experiencing today. The other thing that we're experiencing today is our ability to, you know, cover many cases when finding enough air transport charter flights to be able to cover many cases in the same evening. The others are more cautionary, just understanding the dynamic and understanding what would it take to scale up the NOP and the training programs, etc. We want it to be prudent, we want it to be cautious, we want it to be thoughtful in our estimates. You know, that's as we see it today. We will continue to look at the guidance. Okay. We will continue to refine the guidance as we continue to execute throughout this year. Excellent. Thanks. What do you see as the greatest impediment for a transplant center for adopting your technology? I mean, one of the comments was regarding the kind of concentrated success you've seen. What’s been the impediment in getting to some of the other centers to adopt at this point? I don't see it as an impediment, Bill. We have been engaged with fairly broad number of centers. It's just the time it takes to wrap their heads around the NOP. We all know the transplant community is a super conservative group. They've been doing it one way for the past 50 years, and here we come transforming that completely into a more streamlined process that is managed by third party. We just wanna be prudent. We want them to get to where we are on their own time. We don't wanna force anything. It's just the time it takes for them to wrap their head around the NOP. That's really it. You know, we you know as a part of that is understanding that any service costs, in addition to product costs, is coming from the Organ Acquisition Cost Center. Seeing the outcomes that are being delivered using NOP compared to outcomes, you know, through the direct acquisition. This is really it. We are growing, and we're proud of the number of centers that have adopted NOP, but we don't see major impediments. It's just the time it will take to convert the bulk of the market to NOP. We have to be careful not to rush things, let things mature in the appropriate pace, because we're transforming the standard of care. Everybody knows that transforming the standard of care doesn't happen overnight. We're laying a solid growth foundation for 2023 and 2024, not just 2022. This is why we're being prudent and we're being very careful to allow centers the time they need to get their head around the NOP concept. You know, the last question was, you know, there was an article in the Post today, and, you know, I think that the real question is how would a breakup of UNOS impact you, especially, you know, given that, you know, UNOS oversees the OPTN. Then, I think they have the Wednesday Senate Finance Committee hearing. Yeah. Yeah. Bill, you know, as I've said publicly numerous times, we are not, we don't have any interest in commenting on any legislative or federal mandates to break up UNOS. I don't think UNOS is gonna be broken up anytime soon. You know, we have to continue to play within the construct of the federal structure of organ transplant. What we present into this argument is something that is very positive, something that presents a solution, not pointing to an antiquated part of the system. We're pointing that the OCS and the results achieved by OCS represent the highest rate of solid organ utilization in the history of organ transplant in the United States. Number 2, that for the last 18 months, the NOP has demonstrated significant success in growing transplant programs volume in accessing new donor pools like DCD donors and extended criteria DBD donors. And that TransMedics managing that, successfully, to do more cases, and the case number is growing, you know, quarter-over-quarter, month-over-month, you know, on daily basis. That's what we present. We present a positive solution to this very complicated problem. We will operate within any federal structure, whether it's UNOS or another structure. You know, we don't see that as something that we should be too concerned about. We want to make sure that our voice and our data and our technology and our NOP is factored into all these national discussions around revamping the organ transplant system in the United States. Great. Thanks for taking my questions. Thank you. Our next question comes on the line of Cecilia Furlong with Morgan Stanley. Your line is now open. Thanks. This is, Calvin on for Cecilia. Thanks for taking the questions. Two from me. First, I wanted to ask more on heart traction within the NOP. It sounds like heart NOP mix stepping up from 30% to about 57%, which is a very positive update to hear. I'm just curious, where do you see that level trending exiting 2022? But also just what has worked or what have been some of the learnings as you've been ramping up education for these cardiothoracic surgeons towards adopting OCS? Thank you, Calvin. Where do we see the trend? Up. We're working very hard to make sure that the trend continues to grow up and heart to match the other two organs. What's the biggest learning? The biggest learning is to focus on quality of the clinical management of the organ and deliver a better organ than an organ that's managed by the institution staff. This is the laser focus of our team. Without that, it's gonna become very difficult to convince people to leave control to our team. That's what I said to Bill's earlier question. We understand that very well. We know that the cardiothoracic surgical mindset is very focused on outcome. They've been trained to be the ones managing their own organs for many, many decades, and it's just gonna take the time it takes. For us, we lead with data. We lead or we convince them by showing them that if we are managing these organs for them, the outcomes will be better than if their team are managing these organs for them. Got it. Great. Second question really is on kind of ramping of accounts. I was wondering if you could talk a little bit more about pushbacks or discussions you've seen as new centers contemplate, you know, the cost for NOP. What ultimately gets them, you know, comfortable, and really how long is this process taking currently? And also really just what's baked into your guidance around navigating this initial account acquisition process and timing associated with it? Thanks so much. Mm-hmm. Yep. Thank you, Calvin. As I stated earlier, the two key things that we spend frankly all of our time on to sign up a new NOP center is to make sure they understand that how it works, how easy it is to implement. Just get their head around the workflow, the process workflow, and that it is different, but it's not really that much different and that they will always have control over the clinical decision to accept or decline this organ. Number two is to just make sure they understand that every penny that is involved in the service portion, not the technology portion, is a part of the Organ Acquisition Cost Center. That's really it. You know, how much is baked into our guidance? As I stated earlier, we know that we're gonna double the revenue in 2022. Our focus right now is shifted to 2023 and 2024. We wanna establish for the rest of this year a very solid foundation for growth into 2023 and 2024. For that we need to be patient. We need to give the next wave of centers the time they need and convert these centers to be a long-term partner like the ones we've converted already, not just to, you know, have one case a quarter and then they disappear. It's fully baked into our guidance and what's baked in our guidance is our original expectation that we will end the year with somewhere between 10-12 centers per organ. When I say that, it is not 10-12 centers that ordered once. It's 10-12 centers that use the technology a minimum of twice per month throughout the quarter. That number is, you know, we're still far away from that and, you know, or in some organs compared to others. You know, our goal is to end the year at these numbers, and that's what's baked into the guidance. Got it. Very clear. Thanks so much. Thank you. Our next question comes from the line of Josh Jennings with Cowen. Your line is now open. Hi, good evening. Thanks, gentlemen. Congratulations on another strong quarter. I wanted to just ask initially on guidance, another guidance question, I apologize, but just wanted to make sure I was clear that the top end of your guidance does not imply that you have a capacity and the prudent observations you've shared about some of the market conditions. You're not implying that there's a capacity constraint where your current NOP infrastructure and also some of the supply constraints that may come as you're ramping in growth, that there's not a limitation, that $75 million isn't a ceiling for 2022. It's just your prudent outlook for the business for the back half of the year. That's exactly correct, Josh. As I said to Bill, we are not experiencing any or we're not aware of any definitive headwind or a negative situation other than the demand is ramping up and far outpacing our original forecast and updated forecast. That's it. That's all I know. Because of that, I wanna be prudent, I wanna be cautious, and I wanna be conservative. Because again, we take guidance very seriously. I want to reiterate that 75 is not the absolute ceiling for 2022. It's the prudent number that we stand by to make sure that as we are scaling up and we're growing, that we're not inadvertently causing any disruption or any issues that may negatively impact our growth capability in 2023. Again, our laser focus right now is to be able to be in the same situation in 2023. So that's why we're being very deliberate and very cautious and giving the centers the time they need to make sure that we have this solid foundation exiting 2022. Excellent. No, that's clear. Thank you. Just my follow-up on just the drive by CMS, HHS to reform the U.S. transplant network, but also to grow volumes. I think there was a great data point that Arizona Mayo Arizona shared in terms of their liver transplant volume growth in one Q after adopting NOP. Are there any other anecdotal cases you can share just in terms of high volume transplant centers in any organ indication where they've seen that type of growth? I mean, it seems like it's occurring and that Arizona Mayo is, or Mayo Arizona is not a one-off. Thanks for taking the questions. Thank you, Josh. I think rather than naming individual centers, I think I will reiterate what I've discussed publicly before. Based on what we see, based on the results of the first half of the year, we are almost certain that we will see an overall increase in the number of heart and liver transplants in 2022 over 2021, driven primarily by extensive use of DCD livers and DCD hearts, using the OCS and the NOP program. There is more than Mayo Clinic Arizona. There's several large liver transplant programs that are becoming a significant ones dependent on the NOP and integrating the NOP into their workflow, but also they're growing their volume by accessing distant donors, whether DBD or DCD. Definitely the DCD utilization in the United States is at all-time high throughout the first half of this year, just looking at the OCS data and the NOP data that we have. Great. Thank you. Thank you. Our next question comes from the line of Suraj Kalia with Oppenheimer. Your line is now open. Good afternoon, Waleed, Stephen, can you hear me all right? Can hear you just fine, Suraj. Perfect. Congrats, gentlemen, on a nice quarter. Waleed, two questions. The first one, a multi-part question. Waleed, how many sites were doing multiple organs and utilizing NOP? What would predispose one to use NOP for one organ and not another? And maybe you know, Stephen could jump in, just give us some guidepost on the number of sites in each organ so that we can just somehow triangulate the utilization aspect. Sure. Suraj, approximately in Q2, there were a total of 15 centers that have multiple NOP programs within them that used OCS, 15 total across all three organs. The majority of the multi-program we are at least used in two out of the three, if not three out of the three programs. What precludes is sometimes inherent center logistics. For example, one center that we're working with on the heart, it's been taking them 4 months to recruit additional lung transplant surgeons to get their lung transplant program back again up on its feet. That's delaying them. It's just sometimes things that are out of our own control. We're confident that by year-end, we will be able to, with the initiatives that we're working on, get more and more centers to adopt NOP. That's question number one. The second part, which is the macro number of centers that we're after over the next 2 years, is the same number we discussed previously. Anywhere between 30-40 transplant programs in each organ category drive 80% of the volume of that transplant market. That's what we're going after over the next 24 months. Right now, we want to exit 22 between 10 and 12 of those 30 to 40 programs converted to NOP and regularly using OCS as a part of their routine practice throughout the quarter. Yeah, Suraj, I think, you know, we look at it by organ. What I would say is, you know, we talked about 6-12. You know, the high end is on the heart. We have a lot of heart centers because we've dealt with a lot of heart centers historically, and the low end is on the lung, which is kind of the challenged market with COVID and liver somewhere in the middle. Without being specific, that should give you a sense of where we're at. Fair enough. Waleed, I'll just one additional question. Waleed, is NOP really the key driver? You know, obviously, when we look at OUS, I'd love you compare and contrast and, you know, tell us what would it take for OUS. Obviously, there's a huge TAM in the U.S., we get it. Just kind of compare and contrast OUS if you could. Waleed, I did not hear you mention the shortages in the market of dobutamine and dopamine. Presumably, that's not having an impact on you, but just love any additional color there. Gentlemen, congrats again, and thank you for taking my questions. Thank you, Suraj. I think the biggest macro difference between OUS and US as it comes to implementing NOP are two things. One, the lack of national reimbursement in OUS markets that is a huge impediment. The second is some of the European regulations are very different than US regulations when it comes to organ transplant. For example, in Italy, it is illegal that any member of any other medical center to be accompanying a donor organ in the chartered flight back to the transplant program. Some esoteric rules like that could make NOP difficult outside of the US. However, we have positive experiences with replicating NOP in the Netherlands. The only difference is the NOP model in the Netherlands that we worked with them to establish is fully managed and funded by the national healthcare authorities in the Netherlands. They've grown their heart transplant volume by nearly 40% last year using the OCS equivalent of NOP in the Netherlands, where 3 devices with a 3 trained team covered the entire heart transplant programs in the Netherlands, and they're doing great. As I stated in my previous call, there's an interest from the U.K. NHSBT to try to explore replicating the NOP from our experience in the NOP for TransMedics to implement it in the U.K.. Again, these, you know, dealing with NHS and NHSBT takes a long time, so we're working closely with them and, you know, we will continue to pursue this. We're also pursuing hybrid NOP models in Germany and in Italy. These are the initiatives that we have planned to drive to continue to drive growth OUS until national reimbursement is achieved. Thank you. Our next question comes from the line of Allen Gong with JPMorgan. Your line is now open. Thanks. Congrats on the great quarter. Sorry again to touch on guidance, but, you know, I guess just to kind of like put it a different way, you've highlighted that, you know, there's a healthy amount of conservatism being put into your guidance, which I think we can all agree is really prudent given the continued macro challenges. With summer representing a bit of a challenge in third quarter and then holidays representing a bit of a challenge in fourth quarter, how should we really think about the cadence of growth from second quarter to third quarter and then fourth quarter? Does, you know, the middle range of guidance assume essentially, you know, flattish trends? Or should we think of maybe a little bit of a softer third quarter and a step up in the fourth quarter? Yeah. Hey, Allen, this is Stephen. I would think of it as a flattish trend. You know, Waleed mentioned we saw a rebound in July. You know, we have some indication that at least July was decent. I would think of it as flattish over Q3 and Q4. Yeah, I agree, Allen. Again, you know, we just want it to be as realistic and prudent as we can. We hope that we don't see a down trend. We expect it. If one of these things impact us, it will be more of a flat quarter-over-quarter. Got it. Then, you know, how should we think about operating expense growth? I think relative to our own forecast, it came in a little bit higher than we were expecting in the quarter, which, you know, makes sense given all the investments you're doing and the momentum you have commercially. I think the last time we got a guide from you was, I think, on fourth quarter of last year, where you pointed to 25%-30% expense growth. You know, since you're getting so much momentum and, you know, investing into that probably makes sense, should we think about that as at least being at the higher end of that or maybe even being even higher than 25%-30%? Yeah. Thanks a lot. Yeah. Thanks, Allen. That's a good question because we did, you know, see a little bit of higher spending than, you know, than planned due to really, you know, supporting the growth that we're seeing and getting ahead of it. You know, I think at the last call, I talked about expense growth at about a third of the rate of revenue. We probably need to tick that up a little bit, so like from a third to maybe 40%, at least for the next few quarters. Thank you. There are no additional questions waiting at this time, so I'll pass the conference over to the management team for additional remarks. Thank you all very much for taking the time to be in this call. We're looking forward to the next call. Have a great evening. That concludes the TransMedics second quarter 2022 earnings conference call. Thank you for your participation. You may now disconnect your-