On Wednesday, SeaStar Medical Holding (NASDAQ:ICU) discussed first-quarter financial results during its earnings call. The full transcript is provided below.

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Summary

SeaStar Medical Holding reported a nearly 70% increase in Quellimmune net revenue for the first quarter of 2026 compared to the same period in 2025, with revenue totaling $495,000.

The company is focused on expanding its presence in the pediatric AKI market, adding seven new hospitals in the first quarter and aiming for 15 new customers by year-end.

SeaStar Medical Holding continues to progress in its Neutralyze AKI pivotal trial with 198 of the planned 339 patients enrolled, targeting completion by the end of 2026.

The company is working with the FDA on a modular PMA submission for adult AKI, designed to expedite the approval process.

Management maintains a strong financial discipline, with operating expenses remaining stable at $4.1 million for Q1 2026 and a net loss of $3.5 million, improved from $3.8 million in Q1 2025.

Full Transcript

OPERATOR

Hello and welcome to The SeaStar Medical First Quarter 2026 Financial Results Conference call. At this time all participants are in a listen only mode. After the speaker's presentation, there will be a question and answer session. To ask the question during the session you will need to press star 11 on your telephone. You will then hear an automated message advising your hand is raised to withdraw your question. Please press Star one one again. I would now like to hand the conference over to Jackie Cosmo. You may begin.

Jackie Cosmo

Thank you. Good afternoon and thank you for joining The SeaStar Medical First Quarter 2026 Financial Results Conference Call. I'm Jackie Cosman with Wheelhouse Life Science Advisors. Joining me from CISTAR Medical today are Eric Schlarf, Chief Executive Officer, Dr. Kevin Chang, Chief Medical Officer, Senior Vice President of Commercial and Business Operations, and Mike Messenger, Chief Financial Officer. I would like to remind listeners that comments made during this call by management will include forward looking statements within the meaning of federal securities laws. These forward looking statements involve risks and uncertainties and could cause actual results to differ materially from any anticipated results. For a list and description of these risks and uncertainties, Please review CStar Medical's filings with the securities and Exchange Commission. Furthermore, the content of the conference call contains information that is accurate only as of the date of the live broadcast, May 13, 2026. SeaStar Medical undertakes no obligation to revise or update any statements to reflect events or circumstances except as required by law. And now I'd like to turn the call over to Eric.

Eric Schlarf (Chief Executive Officer)

Eric, thank you. Thank you Jackie and thank you all for joining us today. We are making good progress towards achieving our 2026 goals and also maintaining a disciplined use of our financial resources. The increase in our Quellimmune customer base has helped propel our first quarter Quellimmune net revenue with a nearly 70% increase from the first quarter of 2025. With seven new hospitals adopting the Quellimmune therapy in the first quarter of 2026, our goal this year is 15 new customers and we are well on our way to achieving that. With our growing presence and the continued adoption of Quellimmune in the pediatric Aki market, we believe we are on track to meet our net revenue goal of approximately 2 million for the year. More importantly, we are setting the stage for our next and potentially far larger market opportunity in the adult Aki market. To that end, we continue to enroll patients in the Neutralyze Aki pivotal trial with 198 patients enrolled of our planned total 339 patients. Last year we determined that we would add new clinical sites to expand our enrollment efforts to reach completion of enrollment around the end of 2026. Kevin and his team are working diligently to make this happen. It has been extremely rewarding to see the highest caliber medical institutions participate in our trial with UCLA as an example of one of the latest hospitals to join in and more on the way. In addition, we continue to work closely with the FDA on several fronts. First, we are discussing the elements of a modular PMA submission for the adult AKI indication, which we believe could speed the approval process. Second, we are working with the FDA to obtain agreement on rapid approval pathways for our STD therapy. The SCD therapy is a potential life saving therapy for indications where there are no treatments today and we believe patients with hyperinflammation should have more immediate access to therapies that could reduce or avoid severe organ damage and potential loss of life. Finally, and before I turn the call over to Tim, we have maintained a strong financial discipline. Mike will share our efforts on this front shortly and now I will turn the call over to Tim to discuss not only our commercial achievements, but how we are building a strong presence in the pediatric AKI community.

Tim

Thanks Eric and thanks everyone for joining us today. I'm pleased to report that we ended the first quarter with strong momentum and it's continuing into the second quarter of this year. As Eric noted, we added seven additional customers in the first quarter and importantly, we are seeing an uptick in orders for many of our customers. Our Quellimmune net revenue in the first quarter was 495,000, a solid increase of 69% from the first quarter of last year. As Eric indicated, this is a small but important market to us, not only because we believe Quellimmune is saving lives and sparing organ function for young kids, but it also provides great validation of our SCD technology and importantly, it paves the way for future potential opportunities in the adult market. We're seeing great enthusiasm by the pediatric healthcare community for Quellimmune therapy. Recently, for example, we sponsored and hosted an educational symposium at the AKI and CRRT meeting in San Diego. Our presence at the meeting and a number of other activities are designed to increase awareness, knowledge and implementation of Quellimmune therapy to continue to build our brand in pediatric AKI and also position CSTAR Medical in a leadership role to help educate the pediatric medical community about this serious unmet need. The symposium provided an opportunity for the pediatric community to get answers to key operational questions gain exposure to the rich content from cutting edge scientific and clinical data and utilize the learnings to establish Quellimmune therapy at the hospitals in which they practice. The broadening impact of Quellimmune therapy and the desire by the pediatric healthcare community to learn more about Quellimmune reinforces a key focus for CSTAR Medical to deepen the educational effort on Quellimmune therapy and how to implement it in the treatment of pediatric AKI. Now, turning to our commercial efforts for Qualimmune in 2026, we have great expectations to help patients by delivering Quellimmune therapy to more pediatric hospitals. We continue to focus on adding new sites as quickly as possible and once a site adopts Quellimmune, ensure pull through by educating the patient care teams so they are focused on pediatric AKI and the option of quellimmune therapy for appropriate patients. We believe this is only the beginning of the commercial opportunities for our SCD therapy and with that I'll turn the presentation over to our Chief Medical Officer, Kevin Chung.

Kevin Chung

Kevin thanks Tim, and thank you to everyone for listening to our call. I want to echo Tim's enthusiasm about our presence at the AKI NCRT meeting in late March. As a critical care physician, I was struck by just how embedded qualimmune has become in the conversation. The interest wasn't limited to our own events or data presentations. It showed up organically in plenary and breakout sessions where clinicians and researchers were referencing qualimmune unprompted. That kind of grassroots visibility in a specialty community is a meaningful signal. Adding to that momentum, the American Society of Nephrology's Kidney News, widely regarded as the newsroom of the nephrology world, dedicated not one but two articles to the SCD therapy in its most recent issue. The first, a feature on the evolution of extracorporeal therapy, identified the SCD therapy as one of the most exciting frontiers in the shift from passive blood filtration to active immune modulation. The second was devoted entirely to the SCD therapy, its mechanism, clinical evidence, and future potential. When the premier nephrology society's publication gives a therapy of this kind, this kind of editorial attention, it is a meaningful signal that the SCD therapy is entering mainstream clinical consciousness. This recognition from conferences and publication is most welcome, but the most compelling recognition comes from the bedside. Every month we convene a virtual Clinical Users call with current and prospective pediatric nephrology and critical care teams from across the country to review every quelloimmune case. Together, the stories we hear on these calls are truly remarkable and they continue to validate and reinforce why getting this therapy to a broader patient population is so important. The SCD's unique immunomodulatory mechanism positions us to potentially, potentially reshape treatment paradigms across a range of serious conditions, not only for aki, but cardiorenal syndrome, cardiac surgery, end stage renal disease and other states of pathologic immune activation where dysregulated cytokine release drives organ failure and death. To that end, we are working diligently to complete enrollment in our neutralized AKI pivotal trial. As a brief overview, Neutralized AKI is a randomized controlled trial designed to assess whether up to 10 sequential 24-hour SCD treatments can improve 90 day survival or renal recovery in critically ill adult patients with acute kidney injury requiring continuous renal replacement therapy. The primary endpoint is a composite of mortality or dialysis dependence at 90 days. We continue to onboard additional clinical sites and now have enrolled 198 of our target of 339 patients. We are targeting completion of enrollment around year end which positions us to potentially report top line results in mid-2027. We are already working with the FDA on our plans to submit a modular pma, enabling us to complete most of the submission with the exception of pivotal data, then submit pivotal data as the last element of the submission. This is designed to allow FDA early review of the modules that don't relate to the clinical trial data. It often speeds the overall review of the applications. Upon completion and review of the neutralized AKI clinical trial and contingent on positive efficacy and safety outcomes, we intend to move quickly to submit the remaining PMA components under our Breakthrough Device designation, positioning us for a potentially accelerated FDA review. A PMA approval of SCD therapy for adult AKI would enable commercialization as a therapeutic device without the IRB related barriers that exist with Quelimune. This would significantly simplify hospital adoption and we believe it will support more rapid commercial expansion. Now let me turn to our SAVE Registry which tracks the commercial use of qualimmune in critically ill children. In March we announced completion of enrollment at 50 patients, a meaningful milestone. We currently we are currently completing the 28 day safety analysis on our final enrolled patients and expect to submit top line safety data to the FDA shortly. Alongside that submission we will formally request that the SAVE Registry transition from its current mandatory status to a voluntary post marketing study. If the FDA agrees this would meaningfully reduce the administrative burden on children's hospitals and accelerating adoption and expanding access to qualimmune across more pediatric centers. A clear win for patients, providers and the healthcare system. With that, I'll hand it over to our cfo, Mike Messenger.

Mike Messenger (Chief Financial Officer)

Mike thank you Kevin. It's great to be a part of this and thank you all for being part of our call today. I'll provide a brief overview of our financial results for the first quarter of 2026. Please note that our Form 10-Q will be filed with the SEC within the next 24 hours, and that will include a lengthier discussion of the Company's financial results for the three months ended March 31, 2026. You can find the [email protected] or through our [email protected] we recorded net revenue from Quellimmune sales of approximately $495,000 for the first quarter of 2026 compared to $293,000 in the first quarter of 2025. And as Tim mentioned, we continue to see strong adoption of quelamine sales here in the second quarter of 2026. Turning to gross profit, our first quarter statement of Operations reflects a gross profit margin of over 90% consistent with the prior three quarters. As a reminder, we didn't recognize cost of goods sold in the first quarter of 2025 as the Quelimmune units sold were originally expensed to research and development prior to approval and commercialization. Consistent with U.S. gAAP operating expenses were unchanged at approximately $4.1 million in the first quarter of 2026 compared to the first quarter of 2025. This represents our continued discipline and leverage of our team's ability to take on multiple tasks within our organization. Due to our broad experiences, talents and enthusiasm to ensure the company's success for the remainder of the year, we anticipate meeting our enrollment goals. We expect our research and development expenses to increase modestly around 5% each quarter as we continue to drive enrollment and support more clinical sites. However, we continue to expect our general and administrative spend to remain pretty consistent from quarter to quarter for the remainder of 2026. Net loss for the first quarter of 2026 was approximately $3.5 million, or $0.90 per share, based on weighted average shares outstanding of approximately 3.9 million shares. This compares with the net loss of approximately $3.8 million, or $4.38 per share in the first quarter of 2025. Based on approximately 862,000 weighted average shares outstanding, we have over $9.3 million of cash on our balance sheet as of March 31, 2026 compared to $5.2 million at March 31, 2025. And now I'll turn it back to Eric.

Eric Schlarf (Chief Executive Officer)

Thanks, Mike. Our goal today was to share with you our recent achievements, but also express how keenly focused we are on the key value drivers for our stakeholders, in particular patients, the medical community and investors. With a small but passionate team, we believe we are reshaping the possibilities for kids that often face organ failure or death without new therapies to modulate the cytokine storm in AKI. Also, by bringing together the pediatric care community to broaden the understanding of critical care in this setting, we believe we are helping to set a higher standard for all kids that face the trauma of acute kidney injury. In addition, we have established relationships with many of the top nephrologists in the country through the participation in our Neutralyze AKI pivotal trial. These relationships will serve us well as we look to potentially launch our SCD therapy in the adult indication. And finally, we are actively engaged with our stakeholders to continue to communicate our value proposition and long term vision for SeaStar Medical. We believe that the opportunities that lie ahead for CSTAR are significant and we look forward to reporting our future progress. With that, I'll ask the operator to open the call for questions. Operator.

OPERATOR

Thank you. Ladies and gentlemen. As a reminder to ask the question, please press star 11 on your telephone, then wait for your name to be announced. To withdraw your questions, please press star 11 again. Please stand by while we compile the Q and A roster. Our first question comes from the line of David Boats with sacs Small Capital Research. Your line is open.

David Boats

Hey, good afternoon everyone. Appreciate the update today. So first question is, have you begun seeing repeat orders from any of these existing pediatric centers? And kind of, if you have, how quickly are those repeat orders happening? From the first time that they come online? Yeah. Hey, David, this is Eric. Thanks for joining. Great question. Hey, Tim, do you want to take that?

Tim

Sure. Happy to do it. Thank you for the question. So, to answer the first part of your question, we absolutely see repeat orders from our customer base. In terms of the speed at which that happens, it is really driven by the presentation of the patient when the patient arrives. In some cases it could be some time between patients and in other times they may finish therapy on one patient and several more will appear in the ICU that are appropriate patients for Quellimmune. So it's fairly unpredictable that way. But it is definitely safe to say that from overall customer base, once they use the product, they gain experience with it. We definitely have repeat orders

David Boats

okay, great. And then you mentioned earlier about the SAVE registry and of course, how encouraging all the data is from that. So at what point do you talk about if that's going to influence treatment guidelines or like standard of care discussions? Yeah, that's a great question. So, Kevin, do you want to tackle that?

Kevin Chung

Yeah. So, you know, standard of care and implementation into guidelines takes a long time. However, if you look at the pediatric AKI consensus document that was published a little over a year ago, immune modulation, extracorporeal immune modulation is mentioned. So I believe that if we continue down this path and we have a positive neutralized AKI study, that pediatric AKI and consensus statement will bring forward the SCD as a therapy that's recommended. And so for these clinical practice guidelines, it takes typically multiple randomized control trials and wide adoption for recommendations to surface. But we're already mentioned there, so that's a good thing. And I have no doubt that with continued use of the therapy as clinical teams see the results, this will become something that everybody's talking about.

David Boats

Okay, great. And then lastly, of course, you mentioned the write ups in the ASN Kidney News. One of the things that they mentioned in there was that integrating the SCD into the ICU workflow is. I think they used the term non trivial. But I mean, how non trivial is

Kevin Chung

it or how easy is it for the unit to be integrated into the protocols at a hospital? Yeah, thank you for that question. Go ahead, Kevin. Yeah, thank you for that question. So clinically, the addition of the SCD cartridge, connecting it serially to an already existing CRRT circuit, any CRRT technician, dialysis technician, or CRRT ICU nurse can do that. It takes minutes to connect and it is as simple as can be. The other thing that a lot of centers around the country have experience with is citrate anticoagulation. And we're fortunate that that's the case because that is a critical component of our therapy. And so, you know, with regards to whether or not it's difficult, if you already have a citrate protocol and you're used to doing CRRT, which 99% of all ICUs in the country, that's a true statement that the implementation of SCD is not going to be difficult. All right, thanks for taking the questions.

OPERATOR

Yep. Our next question comes from the line of Anthony Bandetta with Maxima. Your line is open.

Anthony Bandetta

Thank you. So, yeah, I just wanted to talk about the hospitals that are currently using the product. You know, is, do you have like a particular ordering pattern? Any other color you can Give there. I know you said the reorder frequency. You don't have that exact number, but how many patients total have been treated and do you currently have like, if

Eric Schlarf (Chief Executive Officer)

not a reordering pattern for the hospitals, an average revenue per center or is it really just patient dependent and can vary widely? Yeah, thanks, Anthony. Great question. Thanks for joining today. You know, I'll tackle some of this and then I'll have Tim also come in. You know, one of the things is, you know, how many patients have we treated? We did disclose a couple months back that we had reached the 50 patients for the SAVE Registry registry. So kind of gives you a general sense of, you know, how many have been have been treated. Maybe Tim, you could give a little bit more color on some of Anthony's other questions.

Tim

Sure. You know, I think one way to think about this, Anthony, and thank you for the question is as it is with many products in a hospital, hospitals, once they understand their utilization patterns, will set a PAR value. So that is basically an inventory level that they want to keep on hand all at all times based on their utilization. And to be sure, there are PAR values that have been set with many of the customers that we have, others that are, you know, we're scaling, we're still scaling our business here. Right. So we have 17 customers at this time last year. You know, we, I don't even. We had three or four customers. So it's still new. And so many of these new customers, they order product, they use the product and then they're seeing what the cadence is of patients that come through the system that helps them establish the PAR value. In addition to that too, the more they use this, the more they think about pediatric aki and you heard me talk about the educational efforts that we are really engaging in with a lot of these sites to make sure that there really is a ripple effect of quellimmune across these institutions so that many people know about it and they're actively looking for patients. And when you're actively looking for patients, you're going to tend to find more of those. That's basically how it works. We don't single things out in terms of revenue per hospital at this point. This is an ultra rare indication and condition. And so it really is driven by the presentation of a patient within the hospital system itself. Okay.

Anthony Bandetta

So as you're looking to kind of drive the patient volume and like you said, it's heavily dependent on the patients needing the treatment. But is there any additional education that's going on at the hospitals that you're in and at the new hospitals that you're trying to sign up that, you know, maybe accelerates the adoption at other centers. Yeah, that's a great question.

Eric Schlarf (Chief Executive Officer)

Sorry. Sorry, Eric. No, it's okay. I actually would. Kevin, maybe you could talk about the monthly users call that we have with who's on those calls, what gets discussed, et cetera. Sure.

Kevin Chung

Thank you, Anthony, for that question. I mean, you know, this is a very tight community, the nephrology, the pediatric nephrology and critical care community. And they all talk to each other, they all share experiences. We sort of leverage that spirit and have been having monthly clinical users calls that we talked about in the update and that is attended by, you know, we invite about 135 or 50 individuals. Most often we have about 60 callers that dial in and they get to hear from the previous month's cases that have occurred at each of the sites that are active. And we go into detail about the cases, how sick they were, why they decided, the reason and rationale for therapy, and what happened to them. And now we can't save everybody. But for many of these patients, actually for all these patients, they're very, they're, you know, initiating the SCD at a very, very dire situ during a dire situation where the patient is very, very sick. And virtually all the patients I don't think would have lived without this option. And what we're doing is giving them a chance. And these cases are discussed where the patients are sick, sick, sick. They start Quellimmune. Next thing you know, the inflammatory indices start coming down and they talk about patients doing well. And so, you know, when the participants who don't have Quellimmune at their institution hear these stories, of course they're gonna want to get their hands on them because they want to give their children a chance. And so that's how we spread sort of the message with regards to the potential benefits of Quellimmune. Additionally, we have presented at pretty much the premier conferences where all of the pediatric intensivists and nephrologists gather. Pnrc, which is the Pediatric Research Network Consortium, we presented at it in Miami. Pretty much 50 or so children's hospitals were represented. Society of Critical Care Medicine, akicrt. Even the European meeting that I just returned from, there were several pediatric centers represented there from the United States. And the conversation is always centered around how well these patients respond initially to qualimune. Even when you have a death, they see the inflammatory indices come down and the patients initially improve and sometimes because of the comorbidities, they may not survive, but they see the benefit. And so really it's amplified word of mouth is how I would like to describe it. And it's quite effective. And there are many centers that contact us, although they haven't even begun the process sometimes because they have a child that needs it and we do what we can.

Eric Schlarf (Chief Executive Officer)

That's great, Tim. Yeah, maybe, Tim, you could also just kind of share the newly formed group, this advanced practice group that you've put together.

Tim

Yeah, happy to do that, Eric. So in addition to what Kevin was talking about, we are coming at this from a variety of different ways to educate the community. And one of the things we've done is we formed an advanced provider, practice provider, ad board. So these are folks that are really at the patient care level and they are very operational. They're the ones that kind of get a lot of the work done within these institutions to set up a variety of different orders and protocols. They set up training and these folks are really, they are in many cases the champions within these institutions and taking quellimmune through that hospital system. So we're working with them. We had a symposium at the recent AKI and CRRT meeting. We have several other planned events over the rest of this year. In addition to that, we also have some field level clinical support at these systems too, especially, you know, the systems that have adopted Quellimmune, making sure that again, more people know about it. There are a lot of people at work within a specific hospital. There are a lot of shift changes and so there are a lot of people that need to be exposed to this information. So, you know, I think we have a good handle on what needs to be done and now we're executing on that.

Anthony Bandetta

Okay, great. That was very helpful, thanks. I'll hop back in the queue. Appreciate it.

OPERATOR

Thank you. Ladies and gentlemen, I'm showing no further questions in the queue. I would now like to turn the call back over to Jackie for closing remarks. Thank you, Tawanda. And thank you all for joining us today for the CSTAR Medical first quarter financial results conference call. If you have questions, please contact us at [email protected] or visit our website at www.cstarmedical.com. Thank you and goodbye. Ladies and gentlemen, that concludes today's conference call. Thank you for your participation. You may now disconnect.

Disclaimer: This transcript is provided for informational purposes only. While we strive for accuracy, there may be errors or omissions in this automated transcription. For official company statements and financial information, please refer to the company's SEC filings and official press releases. Corporate participants' and analysts' statements reflect their views as of the date of this call and are subject to change without notice.