Revenue

12 Months Ended

Dec. 31, 2022

Revenue from Contract with Customer [Abstract]

Revenue

15.Revenue

The Company has determined that the payments made to the customer for reimbursement of clinical trial materials and customer’s costs incurred to execute specific clinical trial protocols related to the Company’s OCS products do not provide the Company with a distinct good or service transferred by the customer, and therefore such payments are recorded as a reduction of revenue from the customer in the Company’s consolidated statements of operations. Reductions of revenue related to such payments made to customers for reimbursements are recognized when the Company recognizes the revenue for the sale of its OCS disposable sets.

The reconciliation of gross product revenue to net product revenue for these certain payments is shown below (in thousands):

	Year Ended December 31,
	2022			2021		2020
Gross product revenue from sales to customers	$	77,854		$	30,780	$	27,809
Less: Clinical trial payments		(1,380	)		1,123		2,717
Total net product revenue	$	79,234		$	29,657	$	25,092

Clinical trial payments for the year ended December 31, 2022 include adjustments for certain clinical trial accrual estimates. As clinical trials reach the end of their follow up period, the Company updates its accrual estimates. The Company will continue to update its clinical trial accrual estimates as all information related to clinical trial payments is received.

The Company determined that payments made to customers to obtain information related to post-approval studies or existing standard-of-care protocols (i.e., unrelated to the Company’s OCS products) meet the criteria to be classified as a cost because the Company receives a distinct good or service transferred by the customer separate from the customer’s purchase of the Company’s OCS products and the consideration paid to the customer represents the fair value of the distinct good or service received. As a result, such payments made to the customers are recorded as operating expenses. The Company recorded payments made to customers related to post-approval studies and for documentation related to existing standard-of-care protocols of $1.0 million, $2.1 million and $1.6 million for the years ended December 31, 2022, 2021 and 2020, respectively, as operating expenses.

Disaggregated Revenue

The Company disaggregates revenue from contracts with customers by organ type and geographical area as it believes this presentation best depicts how the nature, amount, timing and uncertainty of the Company’s revenue and cash flows are affected by economic factors, as shown below (in thousands):

	Year Ended December 31,
	2022		2021		2020
Revenue by country by organ(1):
United States
Lung total revenue	$	7,967	$	9,843	$	5,392
Heart total revenue		29,902		10,103		8,599
Liver total revenue		46,169		1,915		5,248
Total United States revenue		84,038		21,861		19,239
All other countries
Lung revenue		880	822		802
Heart revenue		8,451		7,579		5,598
Liver revenue		90		—		—
Total all other countries revenue		9,421		8,401		6,400
Total revenue	$	93,459	$	30,262	$	25,639

(1)Revenue by country is categorized based on the location of the end customer. Total revenue includes product and service revenue. Net revenue includes product revenue only.

When a customer order includes disposable sets and organ retrieval or OCS organ management services in the United States, the Company has determined that the disposable sets and services constitute separate performance obligations and recognizes revenue as the disposable sets and services are each delivered to the customer.