Terumo Acquires OrganOx for $1.5 Billion, An Amadeus Royal Society Enterprise Fund Milestone 

OrganOx turned a harsh reality into a system-level fix: too many donor livers never get transplanted. The company’s metra® platform keeps donor livers in a metabolically active state outside the body using normothermic machine perfusion (NMP) so that functional assessment of the organ can be performed prior to transplant, leading to an increased number of organs available for transplant and better allocation decisions. As of today, it has already supported 6,000+ liver transplants worldwide, with growing U.S. adoption and new operating approvals that expand logistics (including FDA approval for air transport).

Always looking ahead, the team is already working on NMP products to support additional organs, including kidneys, to extend this life saving technology to even more patient populations. With further development, NMP holds the potential to ultimately help heal organs inside or outside the body. Treating and potentially improving the quality of these organs may eventually enable clinicians to offer alternative therapies to patients for whom transplant is the only current life-saving option. 

Why it matters

For patients, NMP has been shown to cut liver discards nearly in half (down to 12% of donated organs), while materially extending preservation time compared to static cold storage. This translates directly into more viable organs reaching more patients, and better long-term graft survival. For clinicians, it builds in flexibility: instead of middle-of-the-night emergency procedures, livers can be preserved for up to 24 hours, shifting surgeries to the daytime with full surgical teams. In practice, this means 84% of transplants now occur during the day with NMP vs. only 65% with cold storage.

Clinical outcomes improve too

NMP is associated with fewer major complications, including lower relaparotomy rates and reduced need for renal replacement therapy. Beyond individual grafts, system-level data shows that after routine NMP adoption, median waitlist time dropped from 79 days to 14 days, transplant rates more than tripled, and crude waitlist mortality fell by two thirds to 6% — with overall waitlist care costs also declining. 

The largest acquisition of any UK university spinout

In August 2025, Terumo signed a definitive agreement to acquire OrganOx for $1.5 billion, marking strategic entry into the organ-transplantation sector and one of the largest UK medtech exits on record. 14 years after The Royal Society first investment in the company, OrganOx evolved into a global leader in organ technology, now turbo-charged by its partnership with Terumo.  

Resilience and drive 

OrganOx always had the potential to transform the future of organ transplantation. It took 18 years from lab bench to global impact. Founded in 2007 as a spin-out from the University of Oxford, the company set out to solve one of transplantation’s most intractable problems: the high discard rate of donor livers. But translating that breakthrough idea into a product was anything but straightforward. Manufacturing a machine that could safely perfuse human organs outside the body required years of engineering iteration, from fluid dynamics to biocompatible materials. Clinical validation demanded rigorous, multi-centre trials across Europe and the U.S., each step slowed by the complexities of transplant medicine and the difficulty of proving safety in life-or-death settings. Regulatory approval took more than a decade, navigating not only the CE Mark in Europe but also FDA pathways in the U.S. with evolving standards around device safety, logistics, and even organ transport. 

Financing and scaling added further pressure: each milestone required patient capital to sustain a business where the product couldn’t be widely commercialised until regulators, clinicians, and payers were all aligned. Even after approvals, adoption required building manufacturing capacity for highly specialised instruments, training clinical teams worldwide, and proving cost-effectiveness to health systems. At several points the company faced existential hurdles — setbacks in trial timelines, regulatory feedback that demanded re-engineering, and the challenge of persuading conservative clinical communities to change practice. 

That OrganOx reached this $1.5B exit is not the story of a single breakthrough, but of persistence across nearly two decades. It exemplifies the vision, grit and talent of founders Prof. Peter Friend and Prof. Constantin Coussios, the work of the management team and co-investors who joined on the journey, and the power of world-class science translated into global commercial impact.