Signature Series: The OrganOx Story | LSI Europe '25

Roger Brooks  0:05  
All right, so we get to do this panel at the perfect time. I think most of you may have heard about the incredible exit story for organox, a company out of Oxford that recently was acquired by truroma for $1.5 billion one of our industry's more amazing success stories, and with me on stage, is Oern, and Sam Oern is the board chair of the company, and then Sam is a key late stage investor that came in. And so let me quickly, if you don't know, organox is a story. It's a company in organ preservation focused on the liver, and they have a, you know, there's, there's a couple of big problems with liver and liver transplant. As First, there's not enough of them. And right now they were harvesting them with putting the livers on ice. And basically, I call it a heart lung machine that they created, but it's for the liver. And so they can keep a liver in great condition and use it up to 24 hours after it's been harvested. And they can also perform diagnostics on it. Prior to organoxers, an incredibly high number of livers that were discarded because they either took too long or they couldn't tell how good the liver was. Now they know how good the liver is. They can keep it alive, and have dramatically increased the number of liver transplants that have happened. And then I want to get into the platform technology. This technology can go a lot a lot of different places with it as well. And I'm going to pick up on something. CARI just spoke about how you look at all these companies and what he say, 95% of them are dogs. And could be true. And I think somebody can look at a company like Oern, can come in and look at a company, and he can develop a vision for it, and develop that vision for success. I don't know how the investors viewed organocks Before Oern arrived, about five years ago, four years ago, five, five years ago. And so keep that in mind of pulling in the right executive chair that's got really good vision and can help tell the story. I'm not saying that organocks would have been highly successful without him, but it was. It was vital to what happened. So they both these guys, introduce themselves and tell a little bit of their story.

Samuel Levy  2:48  
Go ahead, Eric, go first.

Oern Stuge  2:50  
I'm Oern Stuge. MD MBA, previously president of Medtronic, I worked from a board perspective on many companies, 10 exits now, three unicorns, so it's the third one.

Samuel Levy  3:08  
So I'm Samuel Levy. I'm one of the founders of luxera Capital Partners. We're a Paris and San Francisco based healthcare focused growth growth buyout investment firm. My background, I'm American by birth. I have a medical doctor, like, like, Oern, I built a medical device company from an ID napkin to $64 million of revenue, and then founded my investment firm, where we're now managing about $750 million for investing out of a fund to now. And organox was one of our fund one investments. Nice.

Roger Brooks  3:40  
So Oern, why don't you walk us through how you got Yeah,

Oern Stuge  3:47  
I like to start with giving credit to the founders and had the vision to develop an automatic machine perfusion device, which could replicate near physiological condition for a donor organ outside the human body. And as you mentioned, Roger, that would mean that, you know, you don't have to operate 24/7, 365, you can basically put the organ on the machine, and then next day you come in and you look at, for example, the liver. How is the lactate? It is, you know, clearing and the bio production going up, etc. So, you know, you have a functional organ. And then you can do it during day time with all the staff is there, etc, which makes it much better for the, you know, staff, surgeons, anesthesiologists, etc. And, you know, we saw that complication rates dropped 50% utilization of organs went up significantly. And that's, you know, there's shortage. So that's an important part. So it was big added value there. Now they launched in Europe, and 12 years out, they were running out of money, and there was a fan fundraising and BDF with Tim Maria came in and topped up the funding under one condition that they hire an independent share. And that's how I came in. This was in November 2020, you know, covid we I wanted to meet the founders and the CEO, Craig Marshall, so the only place we could meet was in a hotel room in Stockholm, Sweden, you know. Anyway, we were there and then the the business, after 12 year, made 12, 2.42 point 7 million in revenue, or 2.4 million in revenue, 27% gross margin, and they lost 7 million. And then at the meeting, they told me that, by the way we did here, that we missed the primary endpoint of the primary on the pivotal trial, the FDA trial, so Well, we did a lot of thing the coming five years, which led to revenue multiplying 45 times. We moved gross margin from 27% to 83% and we have about 20% EBITDA margin this year. And you saw the company for 1.5 billion, so it was a steep rise, nice.

Roger Brooks  6:54  
And then, and then you, you got to a later stage, and you were seeking capital. And perhaps,

Oern Stuge  7:06  
before we go there, it might be interesting to say, what are the things we did to really take it, okay, yeah, and the first, I think, was to fix the regulatory part. And they missed the primary endpoint because they had gone for a superiority, you know, endpoint, but they did meet the non inferiority endpoint. And we have a competitor, trans medics, who was had just been approved based on non inferiority. So we hire a really good regulatory consultant who argued the point that, you know, here we have one which has been approved based on non inferiority. We have also the same, you know, why don't we get approval which we did? That was the number one. Big. The writing correctly, right? Very quickly, right now, there's a right consultant, yeah, anyway. Then the next one was to, you know, fix the price. 27% gross margin doesn't work. So I then went through high consulting company to help us with the pricing in the US. There was a lot of pushback from the board, and, you know, some people so it was not good enough with one. We had another one, and then I hired lek to do a launch plan for the US, including price, and they did a very good job. So and there we ended up with a price right. And I will also say that it is crucially important that the innovative companies in Medtech and everywhere, I would say, deserve a fair share of the added value that we deliver. And if you price it too low, we don't take that. You know, it's hurting everybody so. And I'd like to say one more example on that, if I may. I was president of Medtronic cardiac surgery, where I also founded Medtronic structural heart and came up with a vision to develop a percutaneous heart valve, which we did, and we launched the first percutaneous heart valve in the world, the melody valve in 2006 which meant that we had to set the price in the market. The marketing people, sorry, the marketing and the product manager people came up with, what should the price be? Okay, about the same as a surgical valve, $6,000 well, I understand the rationale, but why don't we go out and check what the cost is? For these children. That is, you know, the target for this Val today and in US, UK and Germany. And it turned out these children had to go through three operations, and that cost $100,000 so with that, I said, okay, the price is $25,000 so we launched it at $25,000 in Medtronic at the time. That sets the stage for the industry. And everybody has, you know, benefit from that since. So anyway, that's another example of where we need a fair price to make it work. And for, you know, the organox part, you know, not only do we reduce complication, we save money about 10 to 20,000 per per operation. So it is a good value proposition for all parties involved. And that's very important. Yeah. Anyway, that's important because a lot of times founders, but then I like to come to you thereafter, after done that, we needed to launch in the US. We needed to find the right leader for the US. And then I called, of course, my favorite, I need help. And you came up with Rupa Basu, which has been absolutely a stellar hire. She's outstanding, yeah, and she deserves a lot of credit for what happened, revenue growth.

Roger Brooks  11:20  
Thank you for that. To those who don't know I'm in the retained executive search business for device companies, both in Europe and the United States. The interesting thing about Rupa is she was in a process before that with another company that was very similar, and the board was not as experienced in med tech. They looked at her, they they didn't see it, but Oern did because of his experience. And so I'm going to go back to the whole idea of having the right board, how critical that is to your process. Inexperienced board members, they kind of live in more of a box. Somebody's got to check all the boxes, but they don't have that in intuitive feel and instinct that comes with years of experiences. So a credit to all those senior people that serve on boards. I think it really helps. Well, let's, let's move, move into SAM once here with the next important, yeah, very, very important. And so as as companies move move down the path, getting the right investors is so important. It's not about getting money. It's not getting the best term sheet, it's getting the right investors. And so I'm going to guess organox had some better term sheets, but they went with Sam for probably for a very good reason. Maybe you could speak to that before Sam starts thinking about why. Well, why Sam? Yeah, what was that process like?

Oern Stuge  12:52  
Well, organixx is very Oxford based, Oxford investors. Nothing bad about that, but I felt strongly that we need to diversify the cap table and get some people with us experience, and, you know, money and basically board experience. So I approached Sam say, hey, why don't you take a look at this? And to your credit, you took it on. You went on and did your own research and came with a term sheet unsolicited to the board, so, you know, and then, yeah, first trade was, price was a bit too low. But then it came, and we, you know, invested, and this has been fantastic. And part of the really critical part of the success story, I would say,

Samuel Levy  13:39  
I think that there's this thinking that, like teams can replace in person meetings. I think we're because that's not true. And I remember at the JP Morgan conference in San Francisco in 23 I had a meeting with Oern. Oern had told me about organox For several years before that, saying, you know, this is the most exciting company I've been a part of. And I said, Oern, you know, we're interested in investing. No, no. We don't need the money. We don't need the money. And then randomly, in January of 23 i surfaced organoxaned, and ern said, Well, you know what? Maybe there is an opportunity this time. And so I built a team, and within my colleagues on our investment team, we started working. We made an offer as to Ernst point, the offer was rejected. I thought when I first heard that, well, this, it's a shame this is over. Kind of slept on it. Thought this is such an outstanding company. Let's improve the price. Let's do it. So I improved the price, but I asked for a long exclusivity period, and what that allowed me to do is fly to the US and meet a substantial number of the company's customers. One of the things that ern said earlier. I'm not sure if everyone picked up on this, but despite growing 146% revenue growth cager from our entry to the exit to tarumo, the company also grew profitably with a 20% cash up a DA margin. And there's like, how is that possible in med tech? Well, it's possible because 75 5% of liver transplants that are performed in the United States are performed in about 60 hospitals. And at the time of our entry, there were about, I think, about 11 or 12 customers. And so we were able to meet about half of them in the US, and we had the the customer level sales data, which for a commercial stage investor, is very, very important to see in store. You know, same store sales growth, and we saw outstanding same store sales growth with no churn across basically the entire installed base. The first question I asked Oern is, how is this company interesting? This is a capital equipment business. How is this investable? Ern said, no, no, no, no. 99% of the revenue comes from the consumable, so that the company basically created an outstanding go to market model in the US, where there what we call the retained unit. The capital is basically leased to the hospital, concomitantly with a contract to buy essentially a million dollars of consumables in the first year. And the consumables have a very, very high gross margin. The overall blended gross margin is 85% and so that business model where, you know, again, customers are ordering in January, they're ordering in February. You know, we love as investors and help deliver the outstanding Exit Multiple that we achieve with with with tarumo. So you know, we did the work. We met the customers. And if you think about transplant, there are donors and there are recipients, you can imagine that there are good donors, bad donors, good donors, bad recipients. Well, the when we talked to customers, what we realized customers were mostly using the product for, you know, bad donors, going into bad recipients. But what we realized was there was incredible traction, primarily because the technology lets the surgeons avoid working in the hospital all night. You know, suddenly transplant surgery, something you can do all day. All of a sudden, the tech, the kind of gateway drug for the device, was the bad donor, bad recipient. But over time, we observed the technology being used in even in good donors and good recipients, and that commercial traction at the account level gave us the confidence to show up, to pay what felt like a very uncomfortable entry price. But, you know, now, now feels intelligent, but at the time, was a bit controversial in my team.

Roger Brooks  17:08  
Yeah, how many? I don't know if everybody picked up on that. There's a there's a minimum set for a customer, they need to commit to a million dollars. I can say that, right? They can. They need to commit to a million dollars, which is maybe x number of procedures a year, 2525 procedures. So it's these centers focus on it. So they focus on this. And it's just, it's a remarkable, remarkable. Okay, so now let's, let's transition it once into, there's two interesting things, I think. First, how did turmoil ever come up as a as a possible acquirer? And then I'd love to dive into, you know, typically, sometimes people hire investment bankers and they get a bunch of people bidding, and that's, that's the you get a good outcome, but it's a it's an incredible amount of lift. And how many companies are ready to fork over $1.5 billion and take on a new market? So tell us a story about, yeah, how turmoil came to be, and why just tarumo? Why not go out and talk to everybody?

Samuel Levy  18:17  
I think we should maybe just, I think one of the main reasons that tarumo, you know, appeared was because of the outstanding commercial traction that the company delivered. I think it might be worth talking for a second about, you know, the how we accomplished that, what it took, even from a team standpoint, working with Roger, to get to get that trajectory. Because I think, you know, I think that, I think that that was absolutely critical. I guess, what I wanted to say was, when we showed up and made our investment, the the the team supporting organox was outstanding, and they were outstanding people to go from, you know, ideation of the technology through to where we were. But I think the reason why tarumo appeared was because,

Oern Stuge  18:57  
actually before, because tarumo is one of the critical suppliers we have. So they knew the company from the very beginning and and there Craig Marshall, the CEO, had a good relationship with one guy you know, in in the supply chain, you know, area of the rumor. And they knew it from there. So when that's also why they were so interested in looking at or investing in the round that we did funding round we did, but clearly they also saw the, you know, the order is going up quite drastically, so that you probably had a you know, influence on their interest, I guess so for sure.

Samuel Levy  19:51  
And I think what you know, Oern, one of the things Oern, told me when we started our discussion, was, you know, I had the very privilege early in my career to grow. Medtech business, more than 100% year over year from a top line standpoint. And you know that that growth brings enormous, I would say, stress, not only to the sales and marketing function, but all the other functions that support the sales and marketing function. So the supply chain, you know, you have more caps mechanically when you have a lot of growth. So the quality system, the regulatory team, you know, when the complications occur in every business that we're in, in this this conference. So when a complication occurs, do we report? Do we not report? How do we manage that stress in the regulatory function? And I think one of the partnerships we had with Roger, and you know, a critical element for this was bringing on board the right people to, you know, lead these, these functions, not from the idea through regulatory approval phase, which requires, I think, a different set of skills, but the commercial scale phase, where you have to really industrialize processes, yeah. And so that was a critical function, totally.

Oern Stuge  20:55  
And, you know, I always, you know, like to over hire for positions. So we hire for the future, not for the present. And then then, you know, you are very good at understanding the demand and come up with, you know, candidates. And I started the Rupa, and you hire one good one, they typically know other good ones. And then that is how it goes, and they know what the standard should be. So you get into the right trajectory right away.

Samuel Levy  21:28  
A's higher, A's and B's higher, C's, yeah.

Roger Brooks  21:31  
And the CFO story was, was kind of a interesting one, where we were marching down the path of looking for a CFO that had the skill set and ability to take the company public. And so we were looking for that public company, CFL scoured the country, and we flew, I think, our top four people to an organ transplant conference in Florida, where Oern and Rupa and Craig were at, and the founders were there, and the team interviewed the group interviewed there, but they're all really good, and they're all in great places today. But I told ern and Sam, there's just one more person that you really, really need to meet. He has already said no to us three times, but he's gonna be at JP Morgan. And I have one of those rooms there, the suites, meeting suites that I spend $1,000 a day on. And I invited him to come by for lunch, to meet Sam and Oern and he said, Okay, I don't have anything to lose. And he's a public company, CFO at the time, not looking very happy. He sat down with these two guys, and at the end of it, he couldn't resist the story, and he made, he made the switch. And I was speaking to Sam the other day about this whole idea of getting multiple suitors, and he and he said something really interesting, that when you've got a strong team and you've got a CFO with the capability of taking a company public, the threat of the IPO helps balance out the pricing, so you don't need a bunch of people competing, because they know what the IPO is going to look like. They can figure that out. And so if you don't have that IPO possibility, I think your offer is going to be a lot lower. But anyway, so it's a credit to knowing the right people and getting the right people aboard.

Samuel Levy  23:35  
So Roger, like continuing to answer your question about how did tarumo kind of appear here, I think one of the really important milestones for the company was actually a private financing that we organized at the end of last year. So I remember, I have four children, and I was at parrot world with them, just outside of Paris, where I live, where all of a sudden I had this kind of panic, you know, I read the monthly revenue growth numbers for organox, which were just outstanding, you know, more than 100% year over year growth. And I thought to myself, I enter this thing as a late stage investor. There are all these early stage investors that funded this thing 15 years ago at a share price much, much lower than mine. Oh, my God. If a tarumo shows up, or someone like that, and wants to pay a kind of normal Medtech multiple, there's going to be huge pressure for me to sell, but I think this is just an outstanding generational company, so we've got to find a way to be able to give it the legs it needs to be more ambitious. And so with the idea that er and I discussed and decided to pursue with our board was the notion of trying to take some pressure off for legacy shareholders and readjust the the exit governance. So we ended up doing $160 million round of financing, of which 25 was primary, 135 was secondary. And we, we collapsed the the liquidation preferences. So the goal being to make the cap table very simple. And we, there was one share price paid for all the secure. 30s, there was no discount for the sellers. And we let you know, we let sellers sell a lot of shares, which we generate a fantastic dpi, you know, proceeds for them and their their LPs. At the same time, we reset the drag rules for the exit. And so we put in place, my firm wrote a term sheet, which we put in the data room available for the future co lead, and we mandated that in order to drag the new investors, there had to be a significant step up from the price that we were paying in that transaction. And that put in place a barrier. That kind of set was it was ambitious set of expectation. I thought was more of like a 26 or 27 number for the company. But when we ended up bringing in two strategics into the transaction, Intuitive Surgical and also tarumo, when they read the shareholder agreement, you know, they knew what our expectations were, and when they saw the revenue trajectory of the business and realized that that public markets were truly a credible threat, they had to make the decision whether to act now, and, you know, just swallow the price or or wait and maybe miss the opportunity. And I'm totally convinced that if we hadn't done that transaction and reset the exit governance, the opening offer from the, you know, the buyer universe, would have been substantially lower.

Roger Brooks  26:17  
Definitely, Sam. Let me simplify something with Sam threw at is a lot of stuff I think most people may not understand, because no, sorry, the world he lives in. But basically, he's got a whole set of early investors that have been around for a long time. They had a chance to exit. So anytime you get a lot of our mid tech companies, they can get tired. You know, people have been in it for a long time. Long time, and I love the idea of organizing something to allow these early investors to get their exit way before everybody else, and then they can, they can move on, and then you clean up your cap table. Your cap table looks a lot more presentable to both for an IPO and the larger investors coming in late. So it keeps it simple. Otherwise, it gets so complicated with too many rights and they walk away because,

Oern Stuge  27:08  
yeah, at least, was a critical move. We wanted to diversify the cap table and get more kind of crossover type of investors in and us, you know, presence and well known name in the US, etc, to be credible on the IPO file, absolutely. So that was one. I also, you know, management had been in there for a while as well. So I encourage people to sell up to a certain percentage of their share, to kind of become a little more patient. Otherwise, you're too keen to take an early offer it, yeah, but it was kind of a bad idea to do, and so we

Samuel Levy  27:50  
routinely do that. We I love buying secondary from founders, yeah. I think they make better decisions as a result. Yeah.

Oern Stuge  27:55  
So, so we executed on that,

Roger Brooks  27:59  
and yeah. So one of the, one of the things I hear about every once in a while, and it just kills moon I hear this, is companies are, they're looking to be bought, and so they, they're focused on working with a strategic to be acquired, and a true story of somebody that I know that goes through the whole process, everybody in the corporation in this larger strategic agreed to buy. They agreed on the price. They're just waiting for the final sign off of the CEO of this major strategic. And that person got to that person's desk, despite everybody wanted to do it, he said, No, we're not going to do it after, you know, lot, a lot of work for a long, long period of time. And I said, Well, did you ever meet up with this, this person? Did you ever speak to him? No, no, never. Never met him. And I think it's so important that your key decision maker, somebody has to mean it doesn't have to be the CEO, it could be somebody on the board, which means getting the right board. If you have the right board and they have the right relationships above, great things happen. And so tell us a little bit about true Mo and I think this is masterful, is is making sure that you got time with the acquirer before they finally pulled the trigger to help that process. Tell us about that.

Oern Stuge  29:26  
Yeah, I met with Hikaru, the CEO of tarumu, and he's head of business development. Ken together with Craig Marshall in Singapore during a conference where they met with several our customers, I went to our symposium quite impressed. It's interesting Japanese and especially tarumo, they are really tall of we saw that in the due diligence, which was off. Yes, I think three times what's normal, they really go through everything in a very serious manner. And, you know, on this meeting, it was they are in advance, asked for my CV, Craig CV, etc, and and then it was about a long discussion about getting to know, you know, me, and what I did as a child and this and that. Yeah. So it was very, you know, an exercise where we actually knew we ended up there a very good fit. Built a trust, build a trust base. It was absolutely super important. So that was most of the dinner was about that. Then I also, of course, knew that Terumo had bid on Inari and lost out, and that, you know, terumou is not used to make too many acquisitions that bankers said they do it every 10 years. And this was now, you know, obviously on the agenda of the CEO. And then I also knew that they could have the potential to vertically integrate the supply chain to 98% and supply chain management is difficult, as you mentioned, and and also for quality, that is a critical part. And we knew that was the case. And I can always not shy about this. And as well as mentioning the fact that if you look at the companies in the Medtech field, which has acquired, you know, systematically, like Boston and Stryker, look at their PE versus the ones that have not. It's half, you know. So I think that that set the stage very nicely. And then I also ran the process together with the car who kind of shepherded this process in a very efficient way, trust based. So that's a helpful idea, and we had very good help from our banker, advisor and lawyers. Yeah, also, like, it

Samuel Levy  32:08  
Did an outstanding job, yeah.

Roger Brooks  32:10  
So it sounds like even I was thinking when you were telling that story, how if, if there's companies out there, like an Ari, and there's other companies that people are trying to acquire, maybe his tosonics was recently acquired, finding out who lost is it might be a good thing, because they're a little pissed off if they didn't get what they wanted, and they're going to come at it and come out in a little more aggressively next time. I'm sure the investment bankers know who those people are, but I like that angle. I know that wasn't the intent, but I have a

Samuel Levy  32:43  
buddy that spent like, 30 years doing, doing them, you know, at Goldman Sachs, doing M A and he told me they all, they always make the list of the most desperate buyers. Yeah, you know, who are the most desperate buyers? Those are the people that we want to talk to first, yeah,

Roger Brooks  32:57  
and, and so I want to shift topics just, just a bit here, because I've got two very, very experienced med tech pros up here. And so I don't know if you guys know Samuel started a company called the Laurie on so he's actually a founder CEO, and ern spent a lot of time in the corporate side, but he's really spent the last 20 years working with early stage med tech, and I get to see a lot of medical device companies that are led by the founder, CEO. This founder, CEO. Not everybody is like Jeff Bezos and Bill Gates, who take it, take it on forever. There's very few med tech stories of the founder going all the way Tim Herbert. I think Inspire is one. But most of the time the founders, if they truly believe in their technology, are passed off at some point in time to hand the reins over to somebody who can scale. Somebody who's seen scale knows how to scale. They get it because usually a founder has never scaled before, and so it could be a first time doing it. So give us some thoughts, advice around a founder, CEO a when, when the right time is to transition. How do they know? How do they know they can't carry it on forever like Jeff Bezos has or Bill Gates, and how do they know when to let it go and tell us a bit about your thoughts on that whole process.

Samuel Levy  34:28  
I think it's hard. It's really hard. I think I think Self knowledge is really important. I think a lot of people that are successful often recognize what their what their strengths are, and what their development areas are. And I think, you know, your point is, right? Like Medtech as a business, it's different than selling books on a website. You know, you sell books on a website, the next thing you got to do is you sell some other product category. Medtech, the commercial the development of companies. The skills and that our need are so different at each step, more different, I would argue, than expanding a marketplace. I mean, Jeff Bezos, I don't want to, you know, I'm not saying it's easy, but in med tech, you got, there's the whole r, d phase, then there's the clinical phase, then there's regulatory phase, there's the commercial phase. Those phases are so different. And it's, it's unusual that people that are brilliant at the engineering are also, you know, brilliant at the commercialization. The only thing I would argue is that no one cares more about the companies and the founders. So there's also, you know, that the problem is that when when things go bad, when you're an investor, you know the operators, the entrepreneurs, you know the employees you hire, they can leave and go work for someone else. At the end of the day, you're left with the equity. And I think the founders had that same mentality. This was my baby. I am not going to let it sink. And you lose that when you transition from from their leadership to the next chapter of leadership. What do you think?

Oern Stuge  35:56  
Ern, yeah, I think you know, exactly right? The founders really care about the business. That's why it's also difficult to let go. Now, we had the in organocks, two co founders who are part time employees. They can, you know, they can do everything, and of course, at the same time, don't want to let go. So it's, it's a challenge, and some issues came up. And I remember once I mentioned the, you know, the founder syndrome. And I said, What's the founder syndrome? And then I just went to chat, GPT took a definition of founder syndrome and sent to the board, and that boom, immediately came a meeting with the founders, you know. But the thing is, then, then I made it not personal, yeah, it was basically chat GPT founder, simple. This is a normal thing. And, yeah, it was a good, you know,

Roger Brooks  36:58  
good this, yeah, not me saying it. I didn't say it, right? Great, yeah, no, it's good for relationship advice. Too many send it on. I didn't say it. Okay, we have, we have a minute. Can we take a question from the audience? If somebody has one, any anybody have any questions they'd love to ask these two gentlemen, either about organocks or about business in general. 

Audience Question  37:31  
This is more from the clinical standpoint with commercialization, but I think it's an amazing story. There's been a huge medical issue that's been solved. Can you talk a little bit about, you know, your customers, and the impact this is having on patients, and the 60 hospitals in particular, in the US and throughout the globe?

Oern Stuge  38:00  
Yeah, I went, I like to go to the big conferences. And one of the first one I went to was that was women in transplantation. And I tell you, that was a depressing session. They were talking about that they give up all the hobbies, the this, and the that and the recruitment for women in especially women in transportation, were going down now two years later, what an optimism, because now it's a daytime surgery, and suddenly it's very popular. You know, interesting. Surgery can be done on the daytime poo hoo that totally flipped things around for them. So that's very important factor, I think. And then the fact is also that complication rates dropped 50% and one of our biggest customers in the US. You know, one of the can I say, No, Cleveland Clinic. They had, they had, before they started, used to the Metro device. They observed 30% about 30% they it's not the secret, because the guy presented it in a constantly. So about 30% sudden cardiac arrest during transplantation. Can you imagine four o'clock in the morning, you are there doing the transplantation suddenly. Patient has sudden cardiac arrest. So then, after they started with the Mitra, it dropped to zero. So that just two examples,

Samuel Levy  39:48  
and I would say for patients, patients that get a liver in the United States have like, weeks of life and the overall survival of patients that get a liver transplantation. Roughly at one year, 90% at five years, 80% at 10 years, 70% so it's truly the gift of life. You're taking people from death doorstep to a pretty good quality of life for most people for decades. Wonderful.

Roger Brooks  40:14  
Well, okay, thank you guys so so much. Really appreciate you sharing the story, and I'm sure you can stop them at any time during the conference, and they'll they'll tell you more. So thank you, everybody. Thank you.