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Condensed Consolidated Statements of Cash Flows - USD ($)
$ in Thousands
 6 Months Ended
Jun. 30, 2023
Jun. 30, 2022
Net cash flows from operating activities:    
Net loss $ (16,914) $ (7,648)
Adjustments to reconcile net loss to net cash from operating activities:    
Change in fair value of contingent consideration 15,700 (5,000)
Depreciation and amortization 11,501 11,497
Non-cash compensation 7,279 6,100
Fair value adjustment of long-term loan 5,000 0
Non-cash lease expense 3,631 3,803
Write-down of inventories and deferred preservation costs 2,021 2,177
Deferred income taxes (8,073) (1,611)
Gain from sale of non-financial assets (14,250) 0
Other 1,836 940
Changes in operating assets and liabilities:    
Accounts payable, accrued expenses, and other liabilities 1,607 (5,677)
Receivables 655 (9,635)
Prepaid expenses and other assets (2,317) (205)
Inventories and deferred preservation costs (6,921) (3,653)
Net cash flows provided by (used in) operating activities 755 (8,912)
Net cash flows from investing activities:    
Proceeds from sale of non-financial assets, net 14,250 0
Capital expenditures (4,029) (4,055)
Payments for Endospan Agreement (5,000) 0
Other (986) (939)
Net cash flows provided by (used in) investing activities 4,235 (4,994)
Net cash flows from financing activities:    
Proceeds from financing insurance premiums 3,558 0
Proceeds from exercise of stock options and issuance of common stock 2,581 2,318
Principal payments on short-term notes payable 529 0
Redemption and repurchase of stock to cover tax withholdings (563) (1,739)
Repayment of term loan (1,381) (1,370)
Other (262) (241)
Net cash flows provided by (used in) financing activities 3,404 (1,032)
Effect of exchange rate changes on cash and cash equivalents 1,030 310
Increase (decrease) in cash and cash equivalents 9,424 (14,628)
Cash and cash equivalents beginning of period 39,351 55,010
Cash and cash equivalents end of period $ 48,775 $ 40,382