LSI Alumni Innovator Spotlight: Centese’s Evan Luxon and Randy Preston

Under the leadership of Co-Founder and CEO Evan Luxon and CBO Randy Preston, Centese is rewriting the playbook for recovery following heart and lung surgery. With more than 15,000 patients treated to date, Centese’s intelligent surgical recovery platform, Thoraguard, is accelerating recovery times, reducing complications, and reshaping the post-operative experience for cardiothoracic patients.

From Incubator to Impact

Centese originated inside San Francisco-based medical device incubator TheraNova, where Evan Luxon worked as Partner in new product development. While researching the clinical benefit of an automated urine output monitoring device, a chance conversation with cardiac surgeons sparked a new idea.

"They asked us if we could do something similar for chest drains," Luxon recalled. "Those devices were even harder to manage, played an integral role in highly complex procedures, and hadn't seen innovation in decades. That was the spark."

TheraNova founder Dan Burnett, MD, introduced Luxon to Randy Preston, an experienced, commercially focused operator with experience in cardiovascular markets. "Evan and I dove in, initially on nights and weekends," said Preston. "We validated the clinical need, talked with leading surgeons from around the country, and explored whether innovating in this field could make a real impact in the lives of patients and healthcare more broadly."

With early support from the National Science Foundation and non-dilutive state funding, Centese began to take shape. Luxon returned to his hometown of Omaha to advance product development, set up pilot manufacturing, and grow the company, while Preston stayed in San Francisco to lead market development, clinical affairs, and commercial strategy.

Thoraguard: Intelligent Drainage That Changes Outcomes

Thoraguard replaces outdated plastic canisters and large rigid tubes with a digital platform that uses continuous monitoring of patient data and proprietary tubes to actively optimize fluid drainage with less pain.

"It’s hard to overstate the clinical importance of drainage after surgery," said Luxon. "It directly affects complications, pain, and how soon patients can go home."

The system collects high-resolution data on post-operative bleeding and surgical site healing, giving surgeons real-time insights. If a complication occurs, it flags it faster. That visibility enables better decision-making, enhanced recovery protocols, and often earlier discharge with fewer residual complications.

"We’ve had clinicians take the length of stay after lung cancer surgery from five days down to under 24 hours," said Preston. "Hospitals are reducing their costs by $15,000 per patient on these high-volume procedures, while patients are recovering faster and safer. It’s win-win, and that’s the kind of impact we aim for."

Clinical outcomes have exceeded expectations, including a 40% reduction in post-operative atrial fibrillation in cardiac surgery patients.

Real-World Traction and Momentum

Thoraguard is now used in over 40 hospitals across the United States, including leading centers such as NYU Langone, Stanford Health Care, Emory University, and the Mayo Clinic.

"We’ve seen record usage quarter over quarter," said Preston. "And that growth is almost entirely driven by word-of-mouth from surgeons and nurses who see the impact firsthand."

In a recent milestone, Centese signed a national Master Service Agreement with Kaiser Permanente, validating both its clinical and economic value at the highest level. "This agreement opens the door to bring the best care to a large consolidated healthcare system like Kaiser Permanente across the U.S., significantly expanding our opportunity to help patients," said Luxon. "It’s a huge step forward."

To support scale, Centese has brought on key leadership, including new COO Hari Agarwal, to accelerate production to high-volume contract manufacturing and Matt Kirby as VP of US Sales, to lead the go-to-market strategy and build out the company’s sales infrastructure.

The LSI Effect

As long-time LSI Alumni, Luxon and Preston credit the community for its lasting impact.

"LSI is a reunion of sorts," said Luxon. "We see familiar faces, share real conversations, and always learn something new. Moonlight Chats last year were particularly memorable."

For Preston, the value goes deeper.

"Medtech startups are really hard. It’s a long road to success," he said. "LSI has become the center of the ecosystem. It’s one of the few places where you can swap war stories, get feedback, and connect with people who understand what we’re facing."

Looking Ahead

With the first close of a $6.5 million funding round completed and commercialization efforts accelerating, Centese is preparing for its next chapter. This includes regulatory expansion into Europe and the introduction of new features for Thoraguard, such as wireless connectivity and decision support through advanced data analysis to enable remote patient monitoring.

The company is laying the groundwork for future generations of its platform. The next generation of Thoraguard, expected in 2026, will incorporate additional AI-powered insights and remote monitoring to enable predictive analytics, earlier discharge, and even hospital-at-home applications. Looking further ahead to 2027 and beyond, the system will provide in-line diagnostics and personalized recovery by detecting biomarkers, such as infections and bleeding, to guide highly tailored care.

"We’re building something that helps patients, hospitals, and surgeons," said Luxon. "And we’re doing it by listening, adapting, and staying focused on real-world impact."

Centese will present its next phase of growth at LSI USA ‘26 in Dana Point, CA.