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Condensed Consolidated Statements of Cash Flows - USD ($)
$ in Thousands
 9 Months Ended
Sep. 30, 2025
Sep. 30, 2024
Net cash flows from operating activities:    
Net income $ 7,342 $ 3,124
Adjustments to reconcile net income to net cash from operating activities:    
Depreciation and amortization 16,701 17,910
Non-cash compensation 20,302 11,499
Non-cash lease expense 3,824 5,860
Write-down of inventories and deferred preservation costs 3,779 2,911
Deferred income taxes (1,484) (4,187)
Change in fair value of contingent consideration 2,390 (12,170)
Losses on inducement/extinguishment of debt 2,664 3,669
Gain from sale of non-financial assets (3,500) 0
Other (7,315) 1,623
Changes in operating assets and liabilities:    
Receivables (924) (3,356)
Inventories and deferred preservation costs (11,563) (4,791)
Prepaid expenses and other assets (4,703) (4,758)
Accounts payable, accrued expenses, and other liabilities (7,193) (5,237)
Net cash flows provided by operating activities 20,320 12,097
Net cash flows from investing activities:    
Capital expenditures (11,534) (9,763)
Payments for Endospan agreements 0 (7,000)
Net cash flows used in investing activities (11,534) (16,763)
Net cash flows from financing activities:    
Proceeds from issuance of long-term debt 0 190,000
Proceeds from revolving credit facility 0 30,000
Repayment of debt (207) (211,765)
Proceeds from exercise of stock options and issuance of common stock 9,613 5,285
Payment of debt issuance costs (1,750) (10,044)
Proceeds from financing insurance premiums 3,117 0
Principal payments on short-term notes payable (1,395) (1,027)
Other (526) (420)
Net cash flows provided by financing activities 8,852 2,029
Effect of exchange rate changes on cash and cash equivalents 2,325 (130)
Increase (decrease) in cash and cash equivalents 19,963 (2,767)
Cash and cash equivalents beginning of period 53,463 58,940
Cash and cash equivalents end of period $ 73,426 $ 56,173