Welcome to the 2024 CareDx Investor Day. I wanna thank all those who have come here to the Nasdaq MarketSite, and for those who are listening to the webcast. A copy of the deck that, or the slides that will be presented today, will be on the CareDx IR website. Here's the obligatory safe harbor. With that, I have the honor of introducing our first speaker, CareDx's President and CEO, John Hanna.
Great. Thank you, Greg, and, I'm John Hanna, President and CEO of CareDx. Thank you all for being here today. We appreciate those in person here at the Nasdaq site, as well as those that are dialing in online and listening to the presentation. The purpose of our meeting today is to share with you how CareDx is differentiated from other molecular diagnostic companies that you can invest in, in the marketplace. My team and I are gonna share with you our strategy for unlocking growth in our current product portfolio that's on market today, and the future products that we intend to launch into the transplant marketplace. Before I begin, I wanna just say that we are proud to be the leading technology company in transplantation. Our strategy, coupled with disciplined execution, is what will deliver an exceptional financial portfolio and returns to investors.
I'm gonna start by talking a little bit about the leaders that you're gonna hear from today, and briefly reviewing our agenda. Following my remarks, Jessica Meng, our Chief Commercial Officer, will present. Jessica joined the company my first week at CareDx as a consultant, and has been my right hand in setting the long-term strategic plan for the organization. Jessica is a sales leader, a marketer, and a culture builder. She's gonna share how we're unlocking growth in our existing product portfolio and capturing the market that we have in front of us in transplantation and solid organs. Robert Woodward is a tenured employee at CareDx. He was one of the first individuals to join the company and is a pioneer in diagnostics and transplantation. He's respected by clinicians and researchers around the globe in this market.
He's gonna share with you a little bit about a topic that's very near and dear to my heart, which is generating evidence for payer coverage and physician adoption, and how we're gonna expand ASPs on our products to drive revenue growth for the company. Keith Kennedy is our Chief Operating Officer. In just a little over a month, Keith has made a tremendous impact on the company. His energy, his drive, his meticulous attention to detail are second to none. Keith is gonna share with you all how investments in technology and business process optimization are gonna drive leverage in our operating model. Keith is a colleague and a partner. We've worked together for a long time, and I still struggle to understand why I have so much gray hair and he has none. Abhishek is our Chief Financial Officer. He's been with the company since 2021.
He helped steer the business through the turmoil of 2023 and brought it out ready and poised for growth. One of the things I love about Abhishek is he spent 20 years of his career at Agilent honing financial discipline, and he's brought that to CareDx. Abhishek is gonna talk about how we're charting a clear path toward profitability as a company. And importantly, Marica Grskovic, our Chief Strategy Officer. Marica is a researcher, a scientist, an operator, and a strategist. She's gonna talk to you about how we're unlocking growth in the future of the company beyond the current eight billion TAM that we addressed today. Marica uniquely is positioned to talk about this as the inventor of the AlloSure product and knows how to create new groundbreaking products that are adopted in the marketplace. Every great strategy starts with contextual awareness.
When I first joined the company, about three weeks into my tenure, I was at a quarterly board meeting where I was sharing with the directors some of my initial observations of the organization, our business, our team, et cetera, in a very casual manner. And a director turned to me very pointedly and said: "You know, you only have a hundred days to figure this out." And I said: "Don't worry, I've got this." I committed to developing a long-term strategic plan for the business and delivering it to the board and investors, and today we're gonna share that plan with you. I always take the perspective of thinking about a company in the context of first the team, the markets they choose to address, and then the products they deliver to win in that marketplace.
CareDx is no different, and so I want to share with you this morning some of my initial observations on my first 100 days at the company. First and foremost, we have an employee base and a team that is incredibly passionate about the care of transplant patients. Each and every one of us at the company has a story to tell as to why we work in healthcare. Many of the employees at CareDx, either they themselves, a family member, or a friend, has undergone transplantation. I myself have a close friend from high school that is a two-time lung transplant recipient, and so we are all deeply connected to this market and the patients we help and the clinicians we serve. We have 650 employees globally, headquartered in South San Francisco, and a European headquarters in Stockholm, Sweden.
We have 180 employees in our commercial organization that are supporting customers and patients every single day. 110 scientists and researchers in R&D that are developing the next generation of products to help further patient health outcomes in transplantation and furthering the evidence on our current in-line products. And we have roughly 80 software engineers in the organization, and these individuals are enhancing and building the next-gen of software products that are helping transplant centers operate more efficiently and improve patient health outcomes. Behind every great company is a great team, and I am incredibly proud of the team that I've assembled here at CareDx. In addition to the speakers that I've highlighted, in the audience today is Jing Huang, our Chief Data and AI Officer, Jeff Novak, our General Counsel, and Michael Goldberg, our distinguished Board Chairman.
I encourage all of you to engage with these individuals today. Following our prepared program remarks, my team and I will be here to talk with each and every one of you, answer your questions, and for you to get to know us and how we think about the future of the business and CareDx. Onto the market. We address a large market in transplantation. There are approximately 250 transplant programs in the U.S. between thoracic and abdominal programs. Importantly, this is a very concentrated market, which allows us to gain leverage on our sales and marketing channel as we sell more solutions into each transplant center.
Today, it's estimated that transplant is a roughly $50 billion market between organ procurement, the surgical procedure to implant an organ, and the follow-up care, both pharmaceuticals, medical device, and diagnostics, as those patients are managed throughout their life. Importantly, this market and this indication is a profit service line for health systems. Health systems are willing to pay additional money in order for new innovation to help drive further transplantation volume in their center and to improve the quality of patient outcomes, the metric by which they're measured and reimbursed. Today, there are approximately 46,000 solid organ transplants performed in the United States. That means that we're spending roughly $1 million per organ transplanted in the country.
Make no mistake, this is a high acuity condition, one in which innovative products can be absorbed and for which there is willingness to pay, both by clinicians, hospital systems, and payers. We are addressing the right market as a company, and as an added benefit, this is a growing market. There is roughly 6% secular market growth year over year in solid organ transplant in the core organs that we're addressing: heart, kidney, and lung. And our products. We have invested as a company more than any other single organization in the transplant market. It's a market that's thirsting for innovation, and we are seeking to rapidly introduce new products in the years to come, and you're going to hear about those products today.
We have a synergistic portfolio of solutions that we offer to the transplant center, and their value is apparent by the level of adoption that they have in the marketplace. To date, we have performed approximately 1 million assays for transplant rejection monitoring. Annually, we ship and deliver roughly 200,000 HLA typing kits to match organs to recipients. 70% of the transplant centers in the United States use one or more of CareDx's software products to help operate their center more efficiently and more effectively. On an annual basis, we are filling 150,000 scripts through our specialty pharmacy. CareDx is the established solutions provider to transplant centers.
With this context, I can confidently say that our business is strong, and I have even more conviction about the company today than I did 100 days ago when I started with the organization. Now, I'd like to share some thoughts about our Q3 pre-announce that was printed this morning. This quarter, we saw growth across all segments of our business: testing services, digital, and lab products. Revenue will be in between the range of $82-$83 million, a 23% growth year over year. Our testing services revenue was between $60 and $61 million, 26% growth year over year, and our testing volume is between 44-45 thousand, a 16% growth year over year. For the most part, the overhangs on our testing services business have been removed.
In August, the Centers for Medicare and Medicaid Services reaffirmed their position that they intend to pay for monitoring assays for transplant, solid organ transplant rejection. In our kidney indication, through the month of September, we began to see a shift in our utilization from for-cause testing towards surveillance testing, and last week, we announced that the DOJ closed its investigation into CareDx with no findings of wrongdoing. Our digital and lab products grew 20% and 7%, respectively, and we ended the quarter with a strong cash balance of $240 million in cash and cash equivalents. I look forward to providing more color on our Q3 at our earnings call in the coming weeks.
Based on our construct of people, team, and products and the situational context I've laid out, I provided my team with a set of guiding principles as to how we think about our strategy and executing it across the business. Those principles start with strong execution, starts with a strong team. We are focused on hiring A players everywhere across the organization. We must put our customer at the center of everything we do as a company. This is a change that I've already made inside of the organization, where we've refocused ourselves on how our customers interact with us versus being focused inwardly on how we sell our products, and Jessica is going to talk about that at length today. We are going to continue to invest in both product innovation and business model innovation to deliver breakthrough growth.
This is the formula for building a successful and enduring healthcare services business. Now, this last point is something that I want to talk about a little bit further because I think it's really important to understanding the context of our strategy as an organization. CareDx is uniquely positioned in the diagnostics market. It's not just because of our science. It's because we have innovated the business model of what it means to be a diagnostics company by providing a portfolio of solutions to service the transplant center holistically. Most molecular diagnostic companies put forward a formula for profitability that starts with addressing multiple large disease indications from early patient screening and identification through to terminally ill therapy selection. Those large indications provide the potential for future revenues and growth, and then through an inward-facing value proposition of achieving operational scale, they hope to reach profitability one day.
By contrast, at CareDx, we've changed the business model to be a healthcare services company. We are the leading solutions provider to transplant centers, and we're offering a solution, a set of solutions that over time allow us to lower our customer acquisition cost in this concentrated market of transplant centers. Ultimately, as we launch new products, we're able to cross-sell them into the same institutions to the same call point, which allows us to gain leverage on our commercial channel. We have teams of people across the country doing staff augmentation services inside of transplant centers, helping them operate their center.
We understand deeply the needs of these organizations, and through our digital business, we're generating multiple terabytes of data on how transplant centers operate that's going to serve as the next wave of innovation for the company in building new products and solutions to help them operate more efficiently, grow their volumes, and grow their profits. This equation, lowering our cost of customer acquisition, cross-selling into the same institutions, and gaining leverage, is a clear formula for profitability of a healthcare services business. And this is how CareDx intends to differentiate itself among its peers to you all, the investment community. To execute this strategy, we have four strategic priorities across the company. First and foremost, you're going to hear from Jessica and Robert today about how we're driving profitable growth inside the business.
Second, Keith and Abhishek are going to talk about how operational excellence is driving efficiency and leverage in our operating model. Third, Marica is going to talk about how we're defining what we call Transplant+ , which is addressing the transplant market beyond the solid organ transplant products that we currently offer today to expand our TAM and the long-term growth of the business. And lastly, all of these initiatives are grounded in driving a culture where we elevate performance across the organization. This strategy is unlocking the intrinsic value of the business, and it's a strategy that will establish CareDx as the most innovative company in diagnostics. I'd now like to welcome Jessica Meng, our Chief Commercial Officer, to the podium. Jessica?
Thank you so much, John. I am very excited to join John and the new leadership team at CareDx because our company has established a strong foundation in the transplant community. We are already making a significant impact on the lives of so many patients, and we still have a tremendous amount of opportunity to drive greater value for our shareholders. So based on the four strategic priorities that John had laid out, the commercial team that I lead is intensely focused on the number one strategic priority, which is to drive profitable growth. So now let's talk about why we're so committed and passionate about the patients we serve in this community. Organ transplantation is not just a market. It is a calling, and it is a vital service.
Over the past year, there were forty-six thousand organ transplantations that were performed in the United States, and because of all the healthcare advances that have been made, including CareDx's own innovations, patients are living longer and fuller lives. Currently, there are over four hundred thousand patients who are living with organ transplants, which is amazing, and they all need long-term follow-up and monitoring of their graft health. Because for a significant portion of them, their transplanted organs will actually eventually fail during their lifetime. So this is where CareDx's testing services come in, to provide that long-term follow-up, because early detection means timely intervention to really preserve the health of our graft for these patients. And a third number that I want to remind everyone is that for every patient that gets a transplant, there are two still on the wait list.
There are currently over a hundred thousand patients on our transplant wait list in the U.S. That is a tremendous amount of unmet need that we must all work to solve, and this is why we're excited to be in this market, and this is why we have a tremendous amount of opportunity to unlock the value in solid organ transplantation. As John mentioned earlier, we have a synergistic portfolio that really addresses many of the challenges that our patients face throughout their transplant journey, and this is why we have a total of an $8 billion market opportunity in solid organ transplantation, $6 billion of which comes from our testing services.
We believe that by strategically wrapping our digital solutions and our lab products around our core testing services, we're going to create a unique value proposition that allows us to capture a greater portion of that $8 billion market potential. Let me talk a little bit more about how we're going to do that. The commercial team has identified four foundational building blocks for growth for CareDx. The first is that the transplant volume in this market continues to grow in mid-single digits, and we must leverage that growth. Second is that with our portfolio, we have the opportunity to drive greater customer adoption and really become partners to our solid-organ transplant centers who are at the core of our customer base. Third, there remains a major challenge in driving patient adherence to testing, and we can really help resolve and improve that.
And fourth, we must continue to accelerate our launches of our pipeline product to address continued unmet clinical needs in this space and for our patients. So the commercial team that I lead is absolutely committed to developing and executing clear plans of action against each of these foundational building blocks of growth, so that we can better serve our patients, support our customers, and deliver value for CareDx and our shareholders. All right, so let's go in and talk about each of these building blocks. The first building block, as I mentioned, is transplant volume. The transplant market is highly supply constrained. In addition to the 100,000 patients I mentioned that are still on the transplant wait list, approximately over 25% of organs that were donated were discarded last year because they were deemed unviable for transplantation.
This is actually very little known fact outside of the transplant community. So in addition to our passionate patient advocacy community and our dedicated healthcare provider community, we have a number of forces at work really trying to solve the supply constraint and increase the number of transplants available for our patients. Two of the forces I'll talk about are U.S. government and innovation driven by the private sector. A number of initiatives that the government is taking has actually made it into the mainstream media. You've probably been seeing some of the headlines. Let me give you an example. The IOTA model, which literally stands for Increasing Organ Transplant Access, is an initiative that's multifaceted. One of the components is increased government payment to health systems to really encourage them and incentivize them to do more transplants.
On the private sector side, there are a number of perfusion technologies that you may already heard of that are on the market or in clinical trials, really intended to keep organs viable for longer during transit from donor to recipient. Then there are actually a number of anti-rejection therapeutic targets in the clinical trials. One actually just received the FDA Breakthrough Designation last week. If successful, these therapeutic targets are going to enable more patients to receive what's currently called marginal organs to be transplanted, because they're at higher risk of rejection later could be managed with these new therapies. These technological and therapeutic advances are really intended to improve the viability of organs, making organs and reducing that discard rate that we just talked about.
As you can see, there are many forces at work that together are going to continue to improve patient access to transplants and grow the overall transplant volume in this marketplace. CareDx, as the leader and a major player throughout the transplant value chain, is well-positioned to leverage these great forces and leverage the continued growth. Let's talk about the second building block, which is customer adoption. Our field team has really transitioned to take on our transplant center customers as their core focus. By taking more of an account management approach, we're able to create long-term strategic relationships with our customers at these transplant centers and be able to provide greater portfolio adoption. As you know, CareDx has a synergistic portfolio that really addresses many of the acute needs of our transplant centers throughout their patient's journey.
We really need to leverage that synergetic portfolio to really have meaningful conversations and engage with many of the stakeholders throughout the transplant center ecosystem so that we can, as John mentioned, cross-sell, upsell, and actually create custom solutions to address the specific needs of our center customers and create that long-term customer stickiness. Let me give you an example of how we're transitioning from single product selling to our account managed portfolio approach. We have a top ten national transplant center in terms of transplant volume that we started working with years ago. Initially, they were just interested in MedActionPlan, which is a SaaS-based software that provides long-term patient medication adherence. It's actually been adopted at over 40% of transplant centers in the United States.
And through MedAction Plan, we were able to have a lot of meaningful strategic discussions with the entire senior leadership at this transplant center. And we were able to really agree to expand our partnership to really help achieve their strategic goal of becoming the regional leader in transplantation in providing quality patient care. And so today, we have incorporated our entire portfolio of testing services into their clinical protocols. Our lab products are providing rapid and high precision donor matching information in their HLA lab. And we also have integrated a number of digital solutions to provide better patient management, workflow management, and quality management for this center. And by the way, all of our products are fully EMR integrated with this health system and this transplant center. So we're very encouraged by the early results of this account-based approach.
Recently, we conducted analysis to really look at the performance of accounts that had three or more CareDx solutions. As you can see here in red, the three-plus solution accounts had an average 44% new patient acquisition rate for testing services. That's 50% higher than the accounts that didn't have three or more solutions. The three-plus solution accounts also delivered an average $1.2 million just this past year alone, per center, just from testing services. That's 2X the revenue impact compared to accounts that didn't have three or more services and solutions from CareDx. We're, again, very encouraged by the early results from our account and portfolio approach, and we're learning from these early successes, and we're gonna turn best practice into standard practice and replicate the successful model across the country to all of our transplant centers.
I may not have mentioned before, our top 100 transplant center provides over 80% of the transplant surgeries and provide long-term support of their patients, sometimes during their entire lifetime. So it's a highly, highly concentrated marketplace. Now, let's talk about our third building block for growth, which is patient adherence. As I mentioned before, there are over 400,000 patients today in the United States who are living with organ transplants, and all of them need long-term follow-up and care for their graft health and survival. As a result, many of our transplant center customers have implemented our full suite of testing services into their clinical protocols for regular monitoring and longitudinal testing. That's great for patients.
The column in red that you see is based on a number of clinical protocols at these institutions, the average number by organ, that our patients should be receiving in terms of CareDx testing across three years post-transplant. That number for kidney is fifteen, for heart is thirty-eight, because of the combination of our AlloMap and AlloSure, and twenty for AlloSure Lung. But when we look at our real-world data at those transplant centers, what we see is the number of actual tests our patients are receiving is far less than the clinical protocols at those centers. So we have a great opportunity to drive better patient adherence to our customers and our patients' standard care in those centers. But how are we gonna do that? Because patient adherence is one of the most persistent problems that we've faced in healthcare across biopharma and diagnostics products.
Well, we're actually gonna leverage the products in our own portfolio because we actually have a number of patient solutions really aimed at medication adherence in our portfolio. So the first example I already mentioned is MedActionPlan. It's a SaaS-based product that really provides long-term medication adherence. Well, we're gonna incorporate testing adherence to this platform to drive our testing adherence for patients. The second is Transplant Pharmacy, which provides a highly individualized care and medication service for our patients post-transplant. It is well respected in the industry and in the community. Well, we're gonna add our testing adherence to that highly individualized and customized support for our patients.
So by including our powerful improvement adherence tools into our testing services, in how we support those patients, we're gonna be able to improve patient adherence according to the clinical protocols and the orders of these patients' own clinicians and own transplant centers. And the fourth and last building block that I'll talk about is product pipeline. There remains a tremendous amount of unmet need in this marketplace, and our clinicians are looking for solutions. So in the first half of twenty twenty-five, we're gonna launch two expanded indications for our in-line products. The first is to expand AlloSure Kidney for patients with simultaneous pancreas and kidney transplants, and the second is for AlloSure Heart. We're gonna expand our indication to address pediatric patients under the age of fifteen. And then over the next two years, we're going to launch three additional products in the testing services portfolio.
The first is AlloMap Kidney, which serves as a complement to AlloSure Kidney. The second is HistoMap Kidney, which provides additional molecular information to for-cause tissue biopsies our kidney patients receive. And the third is UroMap, which is a urine-based test for patients, a subset of patients with kidney transplantation, that have a type of viral infection called BKV viremia. So we're not baking in a tremendous amount of near-term revenue from the launch of these indications and products because, as you know, the path to coverage and reimbursement is long. However, we really believe that this portfolio of launches, combined with our in-line products, provides a unique and differentiated value proposition for our transplant center customers and our patients, and that we're gonna continue to establish our leadership and become the testing partner of choice for transplant care.
So to summarize, the commercial team has identified four building blocks of growth for CareDx, and the team and I are already at work executing against clear plans of action that we've created to address each of these foundational building blocks of growth. We're gonna leverage transplant volume growth. We're going to drive greater adoption of our portfolio because we've seen portfolio adoptions creates a revenue multiplier for CareDx, and we're going to improve patient adherence and longitudinal testing. And finally, we're gonna launch products that serve unmet needs for our patients. So together, we're looking to serve our patients better, to support our customer set, our customers at transplant centers better, and to drive value and growth for CareDx and for our shareholders. And with that, I'd like to transition to Dr.
Robert Woodward, who is our Chief Scientific Officer, who's gonna talk about our continued effort in evidence generation, which is so critical for our clinical and scientific leadership in this space, as well as to provide better managed care coverage. Thank you, everyone.
Thank you, Jessica. Good morning. It's good to be here in the room with everyone again. Okay, now it's on. So I've had the fortunate opportunity to apply novel diagnostic technologies to transplantation for over two decades at CareDx, and it's... Throughout this time, we have really maintained our focus on cutting-edge science because we've recognized how this is making a difference and is and each patient is depending on it. I've been proud of the work that we have done across a range of products that impact transplant patients. First, from patients, the better matching of organs, best-in-class matching of donated organs to patients, and multiple innovations in post-transplant monitoring and care, but today, I want to focus on one specific aspect of the science in diagnostics, and that's our strategic focus on evidence generation.
Evidence generation is what allows us to drive adoption of our tests in the clinic, expand payer coverage, and prepare the way for our pipeline products that maintain our leadership position in this space. Our continued focus on this evidence is what enables us to continue to be the go-to partner in the transplant care space. So first, I'm going to take us through what's, you know, the typical evidence journey in this industry. Traditionally, clinical utility evidence has been what's been required by payers to see before they'll offer coverage, and but this bar keeps rising over time. It's not a simple set of checkboxes from which you can say, "Okay, well, you got this particular box checked, you're gonna receive coverage." It's a continuous process.
However, this continuous evidence generation does end up with providing the demonstration of value and utility to clinicians that are adopting the tests and prescribing it for their patients, and also those clinicians that are defining coverage at the payer organizations, so this is the typical journey. This is what CareDx goes through. We start with clinical validation, and we have learned from the beginning and over and continue to repeat over time, the value of having prospective multicenter studies to define the clinical validity of our tests. That is, that they're associated with disease, that the level is higher with rejection, that type of thing is the clinical validation.
Importantly, multicenter studies, and then when these centers, these multicenter publications come out, due to the great need for these types of tests in transplantation, there's usually pretty quick adoption of the tests, and this leads to physician adoption publications as well. This is an important component in the evidence journey because their physicians are adopting it early and want to demonstrate to their peers what they're seeing. They want it to publish on whether it's a single case study or something specific, some specific use case, or something more common to a large percentage of the population. The physicians are working to demonstrate to one another the value of these tests.
Sometimes these physician adoption papers, these papers they publish, turn out to be something called a decision impact study, whether it was a planned study or not, demonstrating that there's an impact on decisions they're making in patient care when they use these tests. Ultimately, there can also be designed decision impact studies, those that show ahead of time, prospectively designed, that there is a specific impact that you want to identify: change in procedure, decrease in use of procedures, a decision that's made about patient immunosuppression regimens, something like that. Ultimately, what people usually think of as a clinical utility study is an outcomes clinical utility study. The most commonly thought of is something like in oncology, where this, a particular new drug leads to longer survival for the patients.
That's an outcome that is most common, and that's an outcome in transplant as well. However, there's a lot of other outcomes that can be measured in a clinical utility study and can demonstrate the utility of a test, for instance, reducing invasive procedures such as biopsies, making changes in immunosuppression medication. You can see after the fact, we've done a study, are the patients who were on a particular surveillance using AlloSure, have a lower regimen of treatment, for instance. And an additional outcome that you can associate with that, either directly or indirectly, is that if you're on fewer immunosuppressant drugs, you're gonna have fewer of the side effects from those drugs, such as infections or long-term malignancies that are due to being on these medications. And ultimately, one of the biggest outcomes in this space is quality of life.
Transplant patients receive a transplanted organ as a cure for end-stage organ disease, and when done well, and when done right, they're going back to being normal, productive members of the population. They're no longer sick. They do have to take these immunosuppressive medications. Finding the exact right dose is the goal of many of our clinicians. Ultimately, there can be a meta-analysis of clinical studies. Whether they're large studies or single-center publications that are pulled together in a large analysis, it demonstrates consistency across the studies, consistency across the population. It demonstrates the broad applicability through a large multi-center studies, and that those can be combined together and generate even more data through the power of numbers.
So through our highly intentional approach to clinical evidence generation, we've seen many publications over the years, and I'm gonna talk about two of them from this past year. First is the initial publication from our highly anticipated SHORE study. This is a registry of patients that are on HeartCare that is combined AlloMap and AlloSure. These are two tests that are both correlated with rejection, but not highly correlated with one another. They are looking at different mechanisms. AlloMap is looking at the status of the immune system. AlloSure is looking at the injury to the graft, injury to the organ.
When combined, these provide more value than either one alone, and that was shown in this paper, in this very large study, where there were over 2,000 patients and over 50 centers, and showed that when the two tests are positive, there's a much higher correlation to predict rejection than with either test alone being positive. And this directly resulted in the utility that there are fewer biopsies performed in these patients. So the first step of this fewer biopsies was that in using HeartCare instead of biopsies, and then reflexing to a biopsy when they're positive, physicians used many fewer biopsies at the start of the registry than they would have without these tests.
But the second part of it is that over the course of a registry, and this is one of the powers of a registry, is we're following these physicians over time as they're treating patients starting in the first year, and patients that join this registry in the second year and the third year. That over time, as they learned about how to best use these tests, there was an even further reduction in biopsies, a further reduction of biopsies by 10% in the first year over the course of the study, and a further reduction in biopsies in the second year post-transplant of over 40% over the course of the study. So not only were they using fewer tests to start with, the test has such utility that they learned to use fewer and fewer over time.
These data on reducing the number of biopsies was replicating in this large multi-center registry what had been previously published in two independent studies. Next, turning to kidney, was the publication of an independent study in the highly impactful journal, Nature Medicine. So this is a general medical journal, and it's exciting to see a transplant paper published in a general medical journal that is of high impact. This was, as I said, an independent study. We provided over three thousand results, AlloSure results in this, and to this group. They did the analysis and published the paper. And what it showed was that there was such a large number of patients, they were able to demonstrate that with an odds ratio of over two point three, that AlloSure does have an independent ability to predict rejection.
It's not dependent on any other factor in this multivariate analysis. Importantly, there was such a large number of patients in this study that they were able to look at this ability to independently predict rejection in multiple subsets of patients. Many of the different subsets and different types of patients are published in the paper. Today, I want to point out what's second on this chart, which is in stable patients. This is the ability to identify subclinical rejection, patients that don't have any other signs or symptoms of clinical concern, but it turns out they are experiencing rejection as identified by this test. This was shown in this particular study because they also had protocol biopsies, and it was matched with those. This now demonstrates that you can use AlloSure to identify subclinical rejection in these patients.
This is important because rejection that goes far enough that it's impacting the function of the kidney, can often be irreversible, and so then that kidney is no longer functioning as well for the entire rest of the life of that patient. But if you can identify rejection before it's had that significant impact on the kidney, you can treat it and avoid those long-term consequences. In fact, the KDIGO guidelines for managing kidney transplants recommend treating subclinical rejection, and now this study has shown that, conclusively, AlloSure can identify subclinical rejection, enabling physicians to treat it. And then the third thing on this chart is that there were multiple patients who had more than one biopsy, to which they compared the AlloSure result to the biopsy.
This showed several things, two of which are on this slide, and that is that the AlloSure was elevated outside the normal zone shown in the gray, even before a biopsy-proven rejection, which is, as you're, as we've seen before, a subclinical, you know, identifying earlier a subclinical rejection event. And then following treatment, the AlloSure goes down back towards normal levels when there's successful treatment. What's not shown here is that the AlloSure did not go back towards normal levels when there was unsuccessful treatment. So these are important studies that have made a difference this year already in leading to expanded coverage. And I'll go through all of our four major projects, products here and how where coverage sits. Of course, with AlloMap Heart, we're at 90% coverage when you covered lives, when you consider Medicare and commercial payers together.
Part of that is just because we've had many clinical utility studies, including the randomized controlled trial that showed clinical utility and was published in the New England Journal of Medicine. Importantly, this year, we've seen an increase in the covered lives for AlloSure Heart due to an accumulation of data, but primarily the SHORE study that I just mentioned, an example of that is Blue Cross Blue Shield Federal Employees Plan. They have now written a positive coverage for AlloSure Heart. And this, as I mentioned, was due to the accumulation of evidence, such as the single-center clinical utility studies, as well as the initial SHORE publication. AlloSure Kidney stands at about 60% covered lives, including Medicare and commercial payers.
And an example of the impact of the Nature Medicine, even though that only came out in June, we've already seen that the Highmark Blues Plan offered a positive coverage for AlloSure Kidney, and expressly stated that this publication gave them the confidence to write this coverage. And AlloSure Lung stands at about 30%. It's the newest of these tests, launched only in 2021. It does have Medicare coverage and some private payers. And again, there was a clinical utility study published in 2022 showing that during the pandemic, a set of four centers managed their patients with AlloSure Lung instead of invasive biopsies. So where does this go in the future? These are the studies that we've already published, but we have a...
In addition to independent work with several different centers, supporting some independent multicenter studies, especially in, say, kidney pediatrics, we also have our registry studies, SHORE, KOAR, OKRA, and ALAMO, in each of these organs. And these demonstrate our commitment to this field. These are large studies that we're running over many years to generate the evidence that's necessary, both for adoption and for coverage. So we've already seen the impact of the first initial publication out of SHORE. There will be additional publications from the SHORE study, as well as, as I mentioned, we're supporting some other studies. We'll see this in pediatrics, and we'll see looking at long-term survival and the potential to direct therapeutics independently of biopsy.
In kidney, you know, we're going to see publications about the value of making decisions for the procedures, the value of choosing procedures based on AlloSure, why that's important, the importance of the ability to treat subclinical rejection, and again, long-term survival. ALAMO, I've already mentioned in lung, that we'll be looking at surveillance, subclinical rejection, and coverage for all types of lung transplants. So it's this future as well as the past. The past demonstrates what can be done, the future, what we will be able to do as we follow our intentional path through evidence generation to increase adoption by demonstrating to clinicians the value of these tests, expand payer coverage, and prepare the way for our pipeline. Ultimately, it's the patients who benefit from better care.
Just as we had the confidence to provide 3,000 blinded results for an independent study of AlloSure Kidney, I'm also very confident that these tests will improve the lives of patients by not only improving the quality of their lives with fewer biopsies, but extending graft life, and we look forward to many years ahead in demonstrating those important facts for the patients, so thank you for paying attention to a little bit of the science today. I'll now turn it over to our Chief Operating Officer, Keith Kennedy, and he's going to talk about how we convert this coverage growth into revenue growth.
Thank you, Robert. It's great to see familiar faces in the audience, and welcome to those of you on the webcast. John has such great energy. It's infectious, yet I'm still confused by his gray hair. I thought he was going to mention that I'm from Kentucky, or that I'm sporting a mullet, or I grew up without a television. But I would like to remind John that wisdom comes with age, not with the gray. All jokes aside, as John mentioned, to maximize synergies from our portfolio and capture the full value of our test in a growing market, we must scale the business, drive sustainable growth, and deliver on profitability. For our employees, for physicians, and for patients, we must also be reliable and predictable in our actions and our results. Jessica mentioned the building blocks for our growth: transplant volume, customer adoption, patient adherence, and product pipeline.
Robert mentioned how we plan to drive coverage and adoption through evidence generation. I'd like to share my priorities for the operational team to drive improvement across our key performance indicators, or KPIs. We are committed to maintaining a patient-centric approach, cross-functional alignment, and adherence to our strategic plan, as well as generating industry-leading returns for you, the investor. To do this, John assembled a team that he trusts to execute on the four strategic priorities he laid out earlier: profitable growth, operational excellence, defining Transplant+ , and elevating our performance culture. Critical to ensuring that we have a performance culture is to hold each other accountable for our results. To do that, I'm setting four strategic priorities for the operational team. Think of my role as helping to build a scalable platform for organic and inorganic growth.
Our first priority is to make it easier for physicians and patients to order our tests, and hence, to support Jessica's commercial go-to-market strategy. Our second priority is to scale global operations to drive long-term predictable margins. Our third priority is to deploy best-in-class technology to drive efficient throughput. And our fourth priority is to leverage evidence and clinical utility to improve revenue realization per test while managing our cost. Let me get into the details. Our goal is to make ordering our test easy for physicians and patients. To do this, we must align and integrate our testing, product, and software into our commercial team's go-to-market strategy. In addition, we must maximize EMR and bilateral integrations into all transplant centers and provider locations.
We plan to further integrate and deploy new features in our proprietary digital tools and software to improve the physician and patient experience, including integrating our eligibility and prior authorizations earlier into this process. To scale our operations, we must maintain strict controls on our supply chain, manage our inventory, and keep improving on our cost per test. Our dedicated supply team made significant progress in 2024. We hope to extend those contributions into 2025 and beyond. Since I joined the company just a few weeks ago, I met with my team, and we made important decisions on lab automation projects, how to approach integrating our workflows, and further opportunities to streamline our processes. I've been very impressed with our manufacturing, automation, lab, software, and engineering teams. Physicians and transplant centers ship their tests principally to our lab, located in Northern California.
As we scale our business, we will look at opportunities to improve our patient and physician experience and to deliver results in a cost-efficient manner. The next slide is very important. We hope to take AI, low-code automation, and business intelligence tools to the next level. We recently deployed AI tools to analyze medical records, which significantly cut down on the manpower assigned to those tasks. We hope to further integrate compliant AI tools and agents to improve turnaround times, workflows, and the physician and patient experience. We plan to consolidate various software, operations, and core systems, and to eliminate redundancies and processes across our business. We plan to also build an enterprise data warehouse and business intelligence tools to facilitate a more agile organization that is less dependent on manpower only as our solution. As Robert mentioned earlier, evidence generation increases coverage and adoption for our test.
Though Medicare covers all of our commercial tests, we have work to do to improve the realization of revenue per test for our commercial payers. Our business is not always tied to a contract for a predetermined price. It is incumbent upon us to ensure that we document each order, we check eligibility, we ensure prior authorizations are completed in a timely manner, and that follow-up on claims and appeals are filed when necessary. As we drive coverage, contracting, and compliance, we expect to realize a higher price per test and margin improvement. By controlling cost per test and moderating our operating expenses, we further accelerate margins and profitability. To recap, our four strategic priorities for the operational team are to drive volume, scale our operations, leverage technology across the business, and to accelerate profitability.
Turning to measuring our results, this slide lays out our strategic priorities' directional impact on our KPIs. By focusing on operational excellence and automation, we're going to drive top and bottom line performance. The decisions, investments we are making today will secure a strong future for CareDx, and ultimately drive shareholder value. Our team is committed to operating a best-in-class transplant plus platform company, that John talked about, for our shareholders, so that you can rely on us to scale organically and inorganically. As John discussed in his opening remarks, our strategy, coupled with disciplined execution, will deliver best-in-class, profitable growth and value to you, the shareholder. I want to thank you for the trust you put in us with your capital. Let me turn the meeting over to Abhishek Jain, our Chief Financial Officer. Thank you. Abhishek?
Thank you, Keith. Good morning, everyone. I'm so glad to see all of you here and to those who actually joined us in the live webcast today. To begin, I'm really excited to be part of this leadership team, which is led by John, and also because of the bright future that we have ahead of us. We, together, are driving a business transformation with a hyper-focus on our strategic priorities that will help us chart a clear path to profitable growth and will help us maximize the value for our shareholders. As John described earlier, CareDx is in a unique position to drive profitable growth because of our unique position in a highly concentrated transplant market, low customer acquisition costs, as well as a diverse, yet synergistic portfolio.
Let me share with you the key financial metrics and a financial framework that basically is based on three core pillars. Number one, profitable revenue growth. Number two, expanding our adjusted EBITDA margins and cash generation, and number three, strategic capital allocation. Our first and most important pillar is unlocking profitable revenue growth, and I would want to underscore that it's not growth at any cost, it's profitable growth. We are targeting our revenues to grow at a compounded annual growth rate of 15% in the next three years, and that will propel our revenues to about $500 million by the end of 2027. These revenue numbers are based on the midpoint of our guidance.
We anticipate that our growth is going to be driven by our entire portfolio, including testing services, lab products, and digital and patient solutions, but the bulk of the revenue growth will, of course, come from our testing services business. Our assumptions do not include any M&A-related revenues in these numbers. Coming to the gross margin, we anticipate that we are targeting our gross margins to be above 70% by 2027, and this is for the entire business. This will basically put us in the top tier of our peer group, a 70% plus gross margin by 2027. Improvements in our gross margin are going to be driven by the top-line growth, effective and efficient use of technology, as well as improvements in our ASP, among other things, as we discussed earlier.
Let me move to the second pillar of our financial framework, which is expanding our adjusted EBITDA margins and cash generation and the second pillar is based on the financial discipline to manage our expenses and drive operational leverage. We are targeting our operating expenses to grow at about half the rate of our revenue CAGR growth, and that will help us actually drive solid adjusted EBITDA margin expansion. We are targeting our adjusted EBITDA margins to be 20% by 2027. Being able to improve the adjusted EBITDA margin by three to four times in three-year period is a great testament to the fact that we have a solid earnings power potential.
And by the way, this includes a fine balance, having our ability to invest back into the business, to be able to continue to drive innovation, accelerate growth, as well as continue to drive our operational excellence initiatives. Turning to cash, we are targeting to add over $100 million over the next three-year plan period. And our long-range plan does not require us to raise capital or debt. Moving to strategic capital allocation, which is a key priority for us, and we have developed a framework, a set of guidelines, so that our choices help us maximize the shareholder value. First and foremost is intentional investments in our business development requirements or the M&A needs. That will help us support our strategic priority of being a company with Transplant+.
To help us grow our TAM, increase the breadth of services that we offer, as well as organizing ourselves around the needs of our transplant centers. Second is investing in the growth of our core business opportunistically, where we see outsized returns. As we discussed earlier, there's a long runway ahead of us, and because of the operational leverage, we can actually drive fairly solid incremental profits by driving top-line growth. Third is buying back shares and returning capital to our shareholders as we generate cash and evaluate our cash needs as we move forward. In closing, this is an exciting time to be here at CareDx. We are driven by a commitment, a commitment to serve our patients, a commitment to run the company with a financial discipline and with a focus on profitable growth.
I believe with this, CareDx will have a financial profile, which will be one of the best in our peer group. With that, let me hand it over to Marica, our Chief Strategy Officer, to talk further about the exciting new opportunities beyond our core business. Marica?
Thanks. Thank you, Abhishek, and good morning, everybody. I am excited to be here to guide you today. How, as John mentioned, we are going to continue investing in innovation to deliver future growth. Having been at CareDx for more than a dozen years, I have worked with the greatest scientific minds, and I have led groundbreaking innovations in transplant care, including bringing the world's first cell-free DNA to the transplant patients. I know the market well, and I look forward to expanding our business into adjacent markets that are poised to make significant breakthroughs in bettering patient care. So you heard from John and Jessica how our market is just beginning to realize its potential, and we have a strong plan to drive profitable growth. You heard from Keith how we are building a scalable platform to enable both organic and inorganic growth.
And with that, it is my strong belief that CareDx is extremely well-positioned to expand both within and beyond organ transplantation. By leveraging our core strengths in transplant diagnostics and our patient and center-centric portfolio approach, we have a unique opportunity to unlock value in ways no one else can. So how do we get to, as John noted, Transplant+? Building upon CareDx's long-standing innovation and synergies with our foundational technologies, today, I will walk you through our long-term strategy moving forward, including these three key elements: One, leveraging our core strengths in transplant diagnostics to expand to new indications for transplant biomarkers. Two, extending beyond solid organ transplant monitoring into new adjacent markets. And finally, three, capitalizing on our expansive multidimensional transplant data. By utilizing our unparalleled footprint in transplant and focusing on these three pillars, we are perfectly poised to expand our market beyond the eight billion.
Okay, let's start with our core business area of transplant biomarkers. You heard from Jessica that the transplant market is seeing strong tailwinds, with both technological and medical advances now driving towards greater organ availability. And while Jessica and her team are preparing to serve larger number of patients that are bound to happen with these new technologies, I will show you how these advancements are also providing additional opportunities to apply both our existing biomarkers, but also build new biomarkers across transplant care continuum. So how are we planning to address these markets? Well, first, new organ perfusion technologies are coming to market and are already being strongly embraced. With that, organ discard rate is being reduced. But not only that, there is a bigger donor pool now.
There is now more marginal organs that are now fit for transplantation, as well as there is donation after cardiac death that is allowing these organs that were previously considered maybe not so great, to be used very successfully in transplantation. That all leads to the great need now to assess the quality of these organs. And with that in mind, even today, we have a version of our AlloSure assay that is being used in these perfusion trials to assess organ damage and its impact on transplant outcomes. And in the future, we can foresee having more biomarkers that will help assess the vitality of those organs. Next, there is a number of emerging new therapies. There are new therapeutic targets, there are new modalities, and they hold great promise in treating especially antibody-mediated rejection, which is one of the greatest threats to allograft survival.
Already today, AlloSure is being used in these new clinical trials to monitor patients. And in the future, we envision expanding these trials and the use to other modalities and other biomarkers, such as HistoMap or AlloMap Kidney, that will be used to stratify patients, assess care, and monitor treatment. Finally, and this one is very exciting to me personally, you may have heard through mainstream media, such as New York Times or Wall Street Journal, about these recent formidable advances in xenotransplantation or transplanting pig organs into humans. While these early trials did not quite yet provide long-term solutions, their early success is really raising hopes that soon we will have large-scale trials with pig organs being used. And as this area grows, our molecular solutions are already positioned.
In fact, you may have heard or seen coverage that it was CareDx's innovative xeno solutions that were used in both heart xenotransplants in this area. And knowing that, we are establishing CareDx as the leader in this new xeno transplant technologies that are coming. Okay, let us now look beyond solid organ monitoring and dig a little bit deeper into Transplant+. Our entry into cancer and autoimmune disorders is rooted in adapting our foundational technologies, and is driven by the emergence of new breakthrough therapies that are set to transform patient care, in particular, stem cell transplant and cell therapies. Hematopoietic or blood stem cell transplant has for the longest time been the treatment of choice for certain cancers. And in recent years, CAR T-cell therapy has been established as preferential treatment for certain B-cell malignancies.
In addition, there are modified T-cells that are now being used in clinical trials to deplete disease-causing B-cells, and that has tremendous therapeutic potential in various autoimmune diseases. With these new and emerging markets, we see vast opportunities for patient care management that not only aligns with our foundational technologies, but also shares some aspects of transplant patient care, especially in allogeneic cell transplant setting. Now, let me give you a couple of examples of CareDx technologies already being used in these settings. First off, as CAR T-cell therapy field is evolving, so is the need increasing for standardized patient monitoring and sensitive pharmacokinetic assessment that is accelerating drug development. Today, AlloCell is already being used in our pharma partnerships, where upon treatment with infused cells, they are monitored for their expansion and persistence in patients' blood.
These measures are important because they have been shown to correlate with therapeutic outcomes, such as efficacy and also safety, and physicians can use these measures to aid their treatment and optimizing dosage of cell therapies and administration, defining thresholds which are indicative for successful treatment, and potentially preventing or intervening early before the adverse effects occur. As an example, here we are showing data from one of our partners, Adicet Bio, where AlloCell is being used in their GLEAN study to measure and demonstrate robust dose-dependent response of their CD20-targeted allogeneic cell therapy. Furthermore, higher dose levels of their cells have been associated with better clinical response, demonstrating the AlloCell can be used as a predictor of the effect of the cell therapy.
By engaging in multiple revenue-generating partnerships today that are supporting CAR T trials, we are positioning ourselves to expand our market to allogeneic cell therapy patient management in the future, thereby unlocking significant value in these adjacent markets. Okay, let's look into cancer relapse in stem cell therapy setting. In hemoncology, high doses of chemo or radiation therapy are used to destroy cancerous cells, and that is then followed by hematopoietic stem cell transplant to reestablish healthy blood production. In a successful stem cell treatment, most of the cells in patient will be transplant-derived, and there will be no detectable cancer cells. However, not every treatment is successful, and patients will relapse. In those patients, cancer cells will start to appear, as depicted with the emergence of the red cells here.
AlloHeme is designed to detect these cells earlier than the standard of care because it can detect fewer number of cancer cells due to its being more sensitive. And detecting these changes in cell mixture or cell chimerism can be beneficial to improving post-transplant surveillance. Indeed, on the right, I'm showing data from our ACROBAT clinical trial. It is a trial that is currently ongoing in collaboration with major cancer centers in the United States, such as Dana-Farber, Moffitt, City of Hope, and others. In this trial, AlloHeme, by measuring increases in mixed chimerism, or IMC, is able to distinguish patients that are likely to relapse versus those that are not. And this risk prediction modeling is critical to intervene early, and that is important because earlier interventions lead to better outcomes.
One of our other pharma partners, T-Scan, is using already AlloHeme in their clinical trial of engineered TCR T-cells that are introduced to patients post-HCT to eliminate any residual rising cancer cells and prevent relapse. With these couple of use cases, I have shown you our exploration into these emerging markets, underscoring not only the vast potential that lies ahead, but also our strategic positioning today to capitalize on it. By leveraging our foundational technology and investing in research and partnership, we can bridge the gap between innovation and practical application, paving the way for these groundbreaking solutions to address unmet clinical needs in these very new emerging fields. Now, let's bring it back to solid organ transplant and the power of data. For the past two decades, CareDx has been at the center of many innovations which have revolutionized the field of transplantation.
Today, through the combination of our portfolio of solutions for transplant center management and our patient clinical diagnostic, we sit on one of the industry's largest pre- and post-transplant genomics and utilization data. We are excited about the opportunity to leverage this vast data, along with the public datasets on transplant outcomes, to build care models and drive the next wave of innovation in transplant precision medicine. To emphasize this point, we have already shown that we are the leader in generating clinically meaningful insights from data by bringing AI-enabled rejection risk prediction model, AlloView, to clinical care. AlloView incorporates AlloSure, clinical, and other clinical data points into the management of kidney transplant patient.
And I'm particularly excited that under the leadership of our newly appointed Chief Data and AI Officer, Jing Huang, we will continue to build and apply the power of AI to our expansive datasets, with the goal of deriving actionable insights, improving our customer-facing products, but also enhancing patient care. So to summarize, CareDx has a clear path to expand beyond the eight billion TAM. By addressing new indications for transplant biomarkers and expanding beyond solid organ transplant monitoring and capitalizing on data from our transplant data sets, we are unlocking the potential for exponential growth. I am confident that with our continued focus of innovation and strong partnerships with both pharma and top academic community, CareDx will not only sustain its leadership in transplant diagnostics, but also expand into new markets, creating value foremost for patients, but also our partners and shareholders alike.
With that, I thank you, and I'll hand it back to John for closing remarks. Here you go, John.
Thank you, Marica. As you know, CareDx has a rich twenty-five-year history of introducing innovations into the transplant market that have changed the standard of care for patients and improved patient outcomes. I'm incredibly excited about unlocking the potential of these products that are already on market and new products that we intend to launch into the future. I want to briefly share why I joined CareDx. After three years in the life sciences tools industry, I wanted to get back into a business that was close to patient care, and there's none that I see more important out there than the care of transplant patients. Second, I wanted to demonstrate to you all, the investment community, that LDT lab businesses can be profitable businesses that grow and have a financial profile that's attractive for investment. Much of our agenda today was specific to that topic.
Third, I wanted to bring some of the tools that are out there in the industry that are not yet used in clinical medicine to this indication, and that's something that we'll be talking about in the future as we roll out some of our new products and programs in 2025. Throughout the day today, you've heard how we're taking steps to unlock growth in the business. You heard from Jessica and Robert how we're driving profitable growth through our new go-to-market model and through investments in evidence to drive payer coverage and reimbursement and ASP appreciation of our products. Keith and Abhishek shared how we're executing on operational excellence to drive operating leverage in the business and expand our adjusted EBITDA profitability. Marica covered how we're defining Transplant+ and the future growth opportunities for CareDx.
In each of these areas, we're focused on elevating a performance culture across the organization, and I hope you now have a clear understanding of our strategy going forward as a business. I want to talk a little bit about the elements of growth and achieving the growth rate that we discussed earlier. First, we anticipate the transplant market to have a secular growth rate of mid-single digits over the three-year horizon of our guide. Second, we believe that through our new go-to-market model, the investments that we've made in evidence to drive adoption and deploying our best-in-class programs for patient adherence, together through adoption and adherence, we anticipate our business to grow in the high single digits over this three-year period. Third, our investments in evidence generation will deliver a low single-digit growth in ASPs across our product throughout the period.
And then lastly, we're assigning 1% of growth due to the launch of pipeline products coming from our portfolio. As Jessica described, there's a long journey to reimbursement in the diagnostics market for these products, and we're just getting started on that journey. My expectation of my team and the company is that we deliver on our commitment to exit 2027 with $500 million in revenue, a 20% adjusted EBITDA margin, and add over $100 million in cash to our balance sheet across the three-year period. These are the metrics that we'll continue to talk about on a go-forward basis and our progress toward them in the coming years. We'll provide detailed guidance for each specific year, for example, for 2025 in February in our Q4 call.
And so I hope you've seen today that we are activating our strategy by putting in place the right team, addressing the right markets, and launching innovative solutions that address unmet clinical needs in the transplant space. And collectively, this strategy will make CareDx the most innovative company in diagnostics. I want to thank you all for joining us today. This concludes our prepared remarks for the session. Thank you.