Organ Preservation in Focus: Terumo’s $1.5B Acquisition of OrganOx

Organ transplantation has transformed modern medicine, yet one of the greatest hurdles remains the preservation of donor organs between recovery and implantation. Organ preservation refers to the methods and technologies used to keep hearts, livers, kidneys, lungs, and other organs viable until they can be transplanted into recipients. The effectiveness of preservation directly influences patient outcomes, organ utilization rates, and the economics of transplant programs.

For decades, static cold storage (SCS) has been the gold standard. Organs are cooled on ice to slow metabolism, a simple and inexpensive solution that works reasonably well at scale. But it has major shortcomings: cold storage cannot prevent ischemic injury, it provides no way to test organ function before transplant, and it contributes to the high rate of discarded organs.

Two newer approaches are reshaping the field.

This is where OrganOx has made its mark. The company’s metra system, an NMP platform for livers, allows surgeons to keep donor livers “alive” outside the body, improving utilization and decision-making before transplantation.

Terumo’s Acquisition of OrganOX

In August 2025, Terumo Medical Corporation announced its $1.5 billion acquisition of OrganOx, following a prior venture investment in March. The transaction is one of the largest medtech M&A deals of the year, raising the annual deal count to 31.

For Terumo, a Japanese multinational with deep expertise in cardiopulmonary and perfusion technologies, the move is a natural extension. It reflects a broader trend of global strategics targeting high-value therapeutic areas where patient need and commercial opportunity align. At the heart of this acquisition is the recognition that improving organ preservation could unlock thousands of additional transplants each year.

Market Context: Why Preservation Matters

According to LSI’s analysis, the global market for organ preservation devices is currently worth about $1.9 billion, with liver and kidney transplant procedures accounting for roughly 90% of total volume. Yet supply consistently lags demand.

In the U.S. alone, approximately 100,000 patients are waiting for a life-saving organ.

The problem is not just clinical but economic. Preparing a single organ for transplant can cost between $30,000 and $100,000. Despite that investment, discard rates remain significant: around 30% for kidneys and 10% for livers. Each year in the U.S., approximately 35,000 kidneys and 12,000 livers are recovered, yet only about 26,000 kidneys and 10,600 livers ultimately get successfully transplanted. The gap translates into lost lives and hundreds of millions in wasted healthcare spending.

Machine perfusion offers a way to close this gap, improving both the yield and quality of transplants.

OrganOx by the Numbers

OrganOx has moved rapidly from early-stage innovation to commercial traction:

• The company’s liver metra platform is FDA-cleared and already in clinical use.
• Revenue rose from £12.4 million in FY2023 to £55.2 million in FY2024, a 350% increase.
• The business transitioned from operating loss to profitability in FY2024.
• A kidney-focused NMP device is in development, with commercialization targeted for 2030.

The implications are enormous. By entering the kidney space, OrganOx could dramatically expand its total addressable market. For Terumo, this acquisition consolidates a strong position in transplant solutions while adding a profitable, growth-ready business unit.

Competitive Signals: A Market Heating Up

Terumo is not alone in betting on preservation technologies. In September 2024, Getinge acquired Paragonix Technologies for $477 million, highlighting how strategics are racing to secure footholds in this emerging category.

Analysts at LSI see organ preservation at an inflection point. Growth in the device segment is expected to accelerate at a double-digit compound annual rate as machine perfusion becomes more widely adopted. Large corporates have the resources to tackle hurdles such as higher costs, training needs, and workflow complexity.

For smaller companies, these barriers have historically slowed adoption. But Terumo and Getinge are positioned to integrate these devices into existing clinical infrastructures, smoothing the path for broader use.

Terumo’s Broader M&A Playbook

Terumo has steadily built a portfolio around perfusion, circulation, and hemodynamics:

• In 2011, it acquired CaridianBCT for $2.6 billion, establishing Terumo Blood and Cell Technologies as a global leader in blood component processing.
• In 2017, Terumo bought Bolton Medical, combining it with Vascutek in 2018 to create Terumo Aortic, a leader in complex aortic repair.
• In 2016, Sequent Medical was acquired under MicroVention-Terumo, expanding the company’s neurovascular offering.

The OrganOx deal fits this pattern. After its March 2025 venture investment, the $1.5 billion acquisition cements Terumo’s position in transplantation, an area that sits squarely within its historic strength in flow and perfusion. OrganOx represents a logical extension of this “from perfusion to transplantation” strategy.

Why This Deal Matters

For patients, improved preservation translates into more transplants, fewer discards, and better outcomes. For healthcare systems, it offers a path to reduce costs tied to failed or delayed transplants. For Terumo, it adds a profitable growth engine in a market with significant runway.

The acquisition also signals that organ preservation is no longer an experimental niche but a strategic frontier for medtech investment. Device-enabled perfusion technologies are poised to redefine transplant economics and clinical standards over the next decade.

Looking Ahead

With the backing of a global player like Terumo, OrganOx is well-positioned to accelerate adoption of its metra liver platform and expand into kidney preservation by 2030. Competitor activity, regulatory advances, and growing evidence for machine perfusion all point to a decade of rapid evolution in the transplant space.

The takeaway is clear: organ preservation is becoming a central battleground in medtech. As more corporate acquirers commit resources to this category, the likelihood grows that these technologies will transform both patient outcomes and system economics worldwide.