All right, let's kick it off. Everybody, thanks for coming out to the conference. Hope you enjoyed the lunch keynote speaker. I am here to introduce Will Heyburn from Strata Critical Medical. They are one of the largest operators or service providers of organ transportation services in the country, in addition to cardiac perfusion services. With that, I'll turn it over to Will.
Thanks for the intro. Real quick, we'll talk about some forward-looking statements today. Please check our regulatory filings for more information about that. For those of you that are new to Strata Critical, we are one of the largest providers of both Logistics and Clinical services to the transplant industry, and we use those same resources to provide perfusion services to cardiothoracic surgery centers across the United States. So more than 250 hospitals across the U.S., where we support open heart surgeries with our perfusionists and the associated equipment. We want to start, though, with our mission, because the mission that we perform is really, really important. Every day in the United States, about 15 people die waiting for an organ that's not going to come in time.
There is a huge shortage of donor organs available for people who need them, and that's just counting the people, 100,000 of them, that are currently on the transplant wait list because they qualify. There's multiples of that of people who need donor organs, but they don't qualify to be on that wait list because they're too sick. They have any number of other disqualifiers. There's millions of people who could benefit from an organ transplant, and we're trying to help solve this problem by increasing the supply. It's a very logistically challenging process to recover an organ, because you have only hours to get that organ from the donor to the recipient. It requires dedicated private air transportation, and it also requires synchronization of any number of other Clinical services, the surgical recovery of that organ from the donor, the perfusion of that organ.
That's a fancy word for pumping oxygenated blood through the organ that can repair damage that's done to the organs during the dying process. All of this has to happen in a very specific order and a very short timeline. We put all of these things together for our customers, which are transplant centers. There's 250 of them that have the patient that's going to receive that transplant. Organ Procurement Organizations, there's about 50 of them, and they're responsible for identifying suitable donors and matching them with a potential recipient. We put all of those things together in a one-call solution that allows transplant centers to pursue more potential donor organs and get them to recipients more efficiently with less cost, which helps to close that massive gap between the supply of organs and the demand for them.
Just briefly walking through specifically what we do in each part of our business. Transplant Air Logistics is the largest part of what we do. We have dedicated aircraft across the United States asset-light model. We own less than 30% of the supply that we use to transport these organs. That is 10 airplanes is all that we own. Allows us to be very capital efficient as we grow, and we do not have any need to grow the number of airplanes that we have. We have a small number for strategic reasons. It allows us to compete for RFPs where aircraft ownership is required, and it also allows us to more effectively negotiate with the 70% of our supply base that consists of third-party owners and operators of aircraft.
Aviation, as we talked about, is incredibly important here, because once that organ comes out, it is only going to remain viable for a short number of hours. If we were recovering a heart and a liver for the same transplant center, it is so time sensitive, you would actually use two different airplanes for that. Put the heart on its own airplane, and then 30 or 45 minutes later, put the liver on a second airplane. That is because every minute matters, and if you look at outcomes on a graph, the longer you take to get an organ to its destination, the less likely the outcome is going to be positive for that recipient. It is very, very important to move quickly.
We also harmonize the air transportation with ground transportation using both owned vehicles that are spread across the United States and a network of vetted third-party operators. We couple that with all the Clinical services you need to one phone call to Strata, go and procure a donor organ from anywhere in the country. So that is everything from clinicians that are on call 24/7, 365 to help our transplant centers determine if they are going to accept an organ for transplant. That is called organ placement. We are evaluating if an organ offer that comes in is a good match for a recipient, and then arranging all the administrative items that need to be taken care of to support the recovery of that organ.
That is third-party surgical recovery, meaning sending our own surgeons instead of sending a surgeon that works for the transplant center to recover a donor organ. We will talk about how that can be much more efficient and can save transplant centers money, and also reduce the risk that they fly a transplant surgeon across the country and then come back empty-handed. Finally, the perfusion of those organs. We talked about it briefly, but there is a category of organ donor, Donation after Circulatory Death. This is a donor whose heart has stopped. So much damage is done when a donor's heart has stopped that you need to repair that damage through a process called perfusion. We are one of the largest providers of what is called Normothermic Regional Perfusion.
It is the lowest cost way to repair the damage that is done to those organs because you are perfusing all of the organs inside the body of the deceased very efficiently. We're delivering all of our Transplant Clinical services as much as possible through a local service delivery model. Very differentiated relative to what you see out in the marketplace, because about two-thirds of the time, we're able to bring our clinicians and associated equipment to the location of the donor, either on the ground or via commercial air. This saves our customers a lot of money. It's a very different way than the rest of the industry operates. As we alluded to earlier, those same perfusionists and the same perfusion equipment that you utilize to repair the damage that's done to donor organs can also be used to support open heart surgeries.
We do this in 250 hospitals across the United States. It's a growing part of our business. It's much more efficient for hospitals to outsource that kind of work because we can pull from all across the country to deal with the ebbs and flows of their surgical demand. Furthermore, with our business, we can leverage the staff that we have for transplant and for traditional cardiac perfusion to be a much more efficient model than what else is out there in the industry. Those same kind of people can also support ECMO, autotransfusion, blood management. Very low market share across all of our transplant offerings. It's an extremely fragmented marketplace because the industry has changed so much in the last five years. If you rewind the clock to five years ago, matching was very local.
You weren't allowed to fly across the country, in most cases, to match a donor to a recipient. That was very inefficient because instead of getting a donor organ to the person who's sickest and who needs it most, you got it to a person who was closest. Regulation has evolved, and technology has evolved to allow us to more efficiently get that organ to the person who needs it, who may not have time to wait for another organ. As a result, the industry over decades evolved in a very local model without thinking about the implications of having to transport organs across the country, and more importantly, not thinking about the implications of having to recover organs all across the country. Transplant centers sent their own surgeon for a one-hour flight or a two-hour drive to recover an organ on their own.
Now that that organ could be five hours away, that system has broken down, and it creates a big opportunity for us to start helping transplant centers with that problem, growing both organically and through acquisition. You see the very low market share in organ placement gives us a lot of room to outpace the growth in the market. The same is true in recovery and perfusion, and we have about a third of the market in Logistics. We'll walk through a few highlights of why we think we're best suited to help this industry solve this life-saving problem. We think we're the only one out there that's doing things the way that we're doing them. We have the end-to-end offering that is not captive to any particular medical device.
More and more transplant centers have a variety of choices in terms of different machines they can use to help preserve organs when they are in transit or when they make it back to the transplant center. We are agnostic as to what decisions our customers make. We still believe in that phrase, "The customer is always right," and we just want to make things simple and cost-effective for that transplant center. As you look at the pipeline of new devices that are expected to be introduced to the United States. market over the next three, six, nine months, the machine perfusion space is only going to become more fragmented. Our model allows us to build economies of scale where they exist. That is airplanes that do all the flying for our customers, whether they are using a device or not, it does not matter which device they are using.
The more hours we fly those airplanes, the less they cost to fly. The same is true for our surgeons and our perfusionists. We want them to support any device our customer may use. That allows our surgeons to do more cases, and we amortize whatever we pay them in salary or an on-call fee over more organs, lowering the cost to deliver that service. We have a national footprint to support this project. There is no place in the United States that we cannot support our customers in recovering a donor organ and flying it back to its recipient. Because we have so many local resources available, we are able to dispatch our clinicians more efficiently.
One of the problems with this fast-growing part of the market, Donation after Circulatory Death, which used to be a very small part of the overall industry, and technology has now made it more than half of donation that happens in the United States, is that about 30% of the time when you are pursuing an organ from a donor whose heart is going to stop, you come back empty-handed. It is called a dry run. If you have flown clinicians and equipment from across the country, you are now flying back empty-handed. What we are able to do is dispatch those clinicians and equipment locally on the ground, and only at the point that you know those organs are going to be viable, do you turn on an airplane. It saves a lot of money for transplant centers, and more importantly, it reduces the risk calculus for them.
It allows them to be more aggressive in pursuing a donor that has a higher chance of not having viable organs but still has some chance. More at-bats means more organs that are successfully recovered and more lives are saved. We are very focused on making the process more efficient for those transplant centers. There are a lot of catalysts that we have alluded to so far that are driving the overall growth in the transplant industry. You have seen mid- to high- single-digit growth in number of transplants overall. Donation after Circulatory Death, when you look back over the last few years, has been growing 20% + compound annual growth rate. That is the fastest-growing part of the transplant industry, and that is the part of the industry that we are most exposed to.
If you look at our Clinical business, it grew more than 20% quarter-over-quarter from Q1 to Q2, our Clinical Transplant business. That is because where we support our customers the most are on third-party surgical recovery of Donation after Circulatory Death organs. New technology is also enabling us to widen the aperture of who qualifies to be an organ donor, whether that is normothermic regional perfusion that we provide directly, where you are perfusing all donor organs inside the body of the deceased, or machine perfusion that is increasingly available from a longer list of different providers, now at increasingly lower cost. All of these technologies are allowing more at-bats, more attempts to recover donor organs, and in many cases, from farther away. You are no longer bound by a geographic barrier that stopped so many people from getting the organs they needed in the past.
The regulatory landscape is supporting the new capabilities of these technologies. This is just an example of the way things used to work. Not only were you limited by proximity, you were limited by an arbitrary box, a donor service area that you had to match between. As an example, if you were in Manhattan and there was a matching organ donor across the river in New Jersey, it would not have been possible to use that organ because it was the wrong donor service area. This has already been changed to an acuity circles model, where we look in larger and larger circles for a matching donor until we find one, but it still focuses on geography first. The next frontier is something called continuous distribution. We are using a point system.
Geography is one of those point factors, but you are focused primarily on who needs that organ most. Lungs, which is the smallest portion of what we do today, are the only organ type that have moved over to this new methodology. When they did, you saw an increase of about 80% on average distance between donor and recipient. When you think about our Logistics business, the unit of revenue is hours of flight time. So there is a significant advantage for us as donors and recipients get farther away, but also we are uniquely qualified to help our customers with the challenges of longer distance flights. Legacy operators that evolved to support the older system are using small planes that may not be able to make those kind of trips.
As the industry becomes more efficient and matches donors to recipients that are farther away, you need a provider like Strata that has a flexible fleet, different size aircraft for different missions. We have the larger aircraft that are needed for these long flights. We also have the smaller aircraft and turboprops that are much more cost-effective on the short flights. We do not have a bias towards any particular type of aircraft because only a small amount of our fleet is owned. We can always do what is best for the customer for that particular mission. For a lot of the reasons we talked about, we have the ability to significantly outgrow the organic growth that we are seeing in the marketplace. Number of transplants is growing mid- to high- single- digits, but DCD is consistently growing double- digits. That is where our Clinical business is most exposed.
We can also continue to gain share in this very fragmented market, both organically and through acquisition, which we have deployed very successfully, and we will talk about our strategy there in just a few minutes. We're in the middle innings of this growth in distance between donor and recipient, and already we've seen a more than 60% increase in the distance between donor and recipient across all organ types, even before that change to continuous distribution that we talked about just a minute ago. The way that we are offering perfusion also has the most dramatic benefits for the overall transplant industry. Because we're perfusing all of the donor's organs at the same time for very low cost, you increase the yield, you increase the number of viable organs per donor.
You see here go from 1.7x - 2.6x on average, more than 50% increase in the number of usable organs per donor. Our go-to-market for normothermic regional perfusion is also very unique in that we enter into retainer contracts with those OPOs to provide perfusion for any donors where it is required. These retainer contracts cover all the fixed costs of us having equipment and staff in those locations, and then we can use that equipment and staff anywhere in the region, even outside the region that that retainer contract covers, to support transplant centers all across the country. It's a very unique advantage that we have in the marketplace, and we're continuing to aggressively grow that because having those boots on the ground that can deploy via ground is much more cost-effective than putting everything on an airplane for every single flight.
As we talked about earlier, it helps reduce the risk calculus so that transplant centers could go after more organs. The penetration rate for normothermic regional perfusion is increasing dramatically. Another reason that our business will grow more quickly than the overall marketplace. It's increasing because it works and the price is right. We've gone from around 20% of overall DCD organs being perfused through NRP in 2024 to about 40% last year, and most recently around 60% in the most recent month for where we have data. This is growing very quickly, and we're continuing to see DCD as a larger percentage of the overall pool, and then NRP as a larger percentage within that pool. That's what's causing us to grow at that faster rate than the overall industry.
When you look in European countries that have been doing this for a long time, the vast majority, nearly all of Donation after Circulatory Death donors are perfused using NRP. It's a really cost-effective way of doing this that creates a public good because you're going to have more organs that are usable afterwards. Related to this phenomenon, the transplant centers are increasingly relying on third-party surgeons to recover organs on their behalf. It's related to the distance and it's related to the complexity that we talked about. When you were recovering an organ from a donor in your backyard that didn't require any perfusion, it was very easy to send a fellow on a short flight or in a car to recover that organ.
Now that you're going across the country, four, five, six-hour flight, perfusion is required, and there's a 30% chance you're coming back empty-handed, the math doesn't make sense to take that clinician offline for an entire day and then potentially not have a usable organ. Because we have our surgical network all across the country, we drive someone in and solve that problem for the transplant center, and our surgeons can be much busier. Instead of spending time on airplanes, our surgeons are spending time in ORs. We bring the closest surgeon to recover the organs. That allows us to pay our surgeons more because they're creating more economic output. They're doing more organ recoveries. It also allows them to be more proficient, getting more reps. That's attractive to our customer base. They have more familiarity with the many different kinds of machine perfusion that are available.
They have more familiarity with normothermic regional perfusion. It's a win-win-win for transplant centers, for Strata, and for people who need transplants. It's very much the model of the future, and Strata has already built the platform to deliver that anywhere in the country. Finally, we wanted to touch a little bit on the inorganic opportunity we see here. We talked about it a little bit earlier, but the industry was built to support local donor-recipient matching. Small mom-and-pop providers of small airplanes that don't fly very far, small surgical recovery providers that work for a transplant center near where their business is based and don't need to go very far from it. All of that is breaking right in front of our eyes.
It creates an opportunity in that these excellent providers realize that they don't have the national scale they need to provide the services that they want to provide at the cost structure that's increasingly required from their customers. But also, when we plug these acquisition targets into our platform, we're able to turn upside down the way they operate and make it much more efficient. If there's a target in a given location working for a hospital in a given location, they were putting those surgeons on airplanes to pick up an organ from somewhere else. When we acquire that target, we're now using those surgeons for all of our customers when they are recovering from a donor in that area.
For the customer that we acquire with that target, we're using our surgeons elsewhere in the United States to recover for them when they have a donor in those areas. The surgeons become busier. They become more efficient. It fits into the network, and we're able to provide better service to everyone. We've been able to complete these acquisitions at mid-single-digit multiples of free cash flow, create synergy. We've got a great pipeline of further acquisitions in this space, and we view it as a complement to our organic growth strategy that's off to a fantastic start, as we talked about Clinical organic growth more than 20% from Q1 to Q2 2026.
Really, really fast evolution that's resulting in an acute need for what we do on the Cinical side, and then Logistics are directly linked to that. We've continued to have good year-over-year growth in our Logistics business. We're looking at acquisition targets in all of the areas in which we operate. That's Transplant Clinical. We recently made an acquisition in June of another surgical recovery provider. It's off to a fantastic start. You'll also see us look at third-party normothermic regional perfusion providers. That's within the Transplant Clinical umbrella as well. Within the Logistics side of our business, we are looking at opportunities to bring logistics providers into our umbrella, as well as organ placement providers. Organ placement is reported in our Logistics segment because of the administrative work that's required to set up those organ placements.
We recently announced an acquisition in that space as well, all at mid-single-digit multiples of free cash flow. Outside of transplant, we see a really attractive opportunity to keep building our cardiac perfusion business and feeding the overall transplant business at the same time. We've made an acquisition in that space that we announced earlier this year, Louisville Perfusion Services, approximately $3 million of adjusted EBITDA. We have many more in the pipeline in that area. This is a growing space across the United States. because, again, these hospitals are not able to efficiently manage the ebbs and flows of demand they have for perfusion, particularly in regions that are not as dense as places like we are today or New York, where our company is based.
You're simply paying to overstaff perfusionists who are mostly not going to be doing cases just to be able to cover times when someone is sick or when someone goes on vacation. When you plug those perfusionists into the Strata platform, you're able to pull resources from neighboring regions. When one region is busy, you can even fly people in if you need to, and you're able to charge that customer much less to be able to cover the same number of open heart surgeries that they would before. With that, I think we'll pause for a second and see if we have any questions in the room. Yes.
I've been on some calls with some transplant services at academic centers that many of them don't seem to value normothermic perfusion or normothermic perfusion, and instead just feel that they can do what they need to do with just ice and cold. I'm just puzzled by. I get the sense that with some of them, it's just a matter of money saved, but for the amount that they're generating on each transplant surgical procedure. I think that's been at least two calls that I remember. [inaudible]
The question was about certain surgeons that don't value normothermic machine perfusion. That's something that we hear from a lot of surgeons. If you have normothermic regional perfusion like we offer, you've now solved the problem of repairing damage that's done to the donor organ. In many cases, we're seeing transplant centers that are comfortable just taking an organ off of a normothermic regional perfusion circuit, putting it on ice, or increasingly, it's a specialized form of ice. We'll leave it at that, a nine-degree cooler. They're seeing great outcomes. I think there's still an important role for machine perfusion to play. We are carrying these kind of devices every single day, and particularly as you go long distances or if normothermic regional perfusion is not available in an area, we could fly it in.
But there's areas where, particularly on thoracic organs, you don't see acceptance of NRP. Yes, we hear that from some surgeons, but we also hear surgeons that want to use machine perfusion for every single heart or every single liver they recover. I think you speak to one surgeon, you get one opinion. Our strategy is to tell that surgeon that they're right and that we're going to get it done no matter what they say. We certainly hear surgeons that have that perspective, and we have surgeons that would like to use a combination of NRP and machine perfusion, and we have surgeons that really prefer machine perfusion. I don't think there's a wrong answer. I think certainly, as you pointed out, the cost is much lower if you're able to recover that DCD organ just using normothermic regional perfusion.
What do you think of the long-term growth rate for the business, both in organic basis and [audio distortion].
The question was on our long-term growth rate. We talked at our Investor Day about how we see a high- teens organic adjusted EBITDA growth rate before the benefit of any acquisitions. We also talked about how we believe that we can accelerate that growth by a further 10 percentage points through our inorganic acquisition strategy. If you look at year- to- date 2026, we've acquired about $6 million of adjusted EBITDA so far, all at mid-single- digit multiples. We're pacing ahead of that acceleration in 2026. On average, over the next few years, that's what we expect. The Clinical side is growing more quickly. As you can see right now, it's been a strong double-digit sequential grower, and we like that setup mechanically for our business because the Clinical business is higher margin and higher free cash flow conversion.
The Transplant Clinical side of our business is more like 30% gross profit margin, 90%+ free cash flow conversion from EBITDA. As that business continues to grow more quickly and as we make more acquisitions in the Clinical side of our business, which is the priority for inorganic capital deployment, you'll see our overall margin and free cash flow conversion continue to improve quarter- over- quarter.
Just wanted to figure out, you talked about DCD. Where does DBD fit into this construct and into your business model? Are there still ethical situations where maybe the donor was brain dead or maybe they are not [audio distortion]?
Donation after Brain Death is still about half of transplants that happen in the United States, and we can perform surgical recovery for that Donation after Brain Death case. Perfusion is not required for that. You do not put a brain death donor on NRP, but some surgeons may elect to use some kind of machine perfusion in that case. Depending on the device, we could be transporting it, we could be transporting it and having our perfusionists operate the device, or we could be having our surgeons do the cannulation to put the organ on the device. More often on brain dead, you will see that organ go with what we call static cold storage, just encompassing both ice and the specialized coolers that are becoming more prevalent in the industry. You also asked about ethical concerns.
We have seen a lot of progress from regulators on this front in terms of standardizing the way that you recover DCD organs, the way that you perform NRP. It is true that there are few geographies left in the United States. where there are limitations around perfusing thoracic organs. In those areas, you have seen really inventive surgeons come up with ways to sidestep the regulatory issue and the ethical issue entirely through things like Vanderbilt's REUP protocol or cardio abdominal NRP, both of which are acceptable in those kind of jurisdictions. I think really important regulatory alignment has already happened, and we now have ways in 100% of the United States to recover those DCD organs without needing to have any ethical issues that would come up there. I think that is all the time. Thank you for the great questions. Thanks for your interest.