Consolidated Statements of Cash Flows - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Net cash flows from operating activities:
Net loss	$ (19,192)	$ (14,834)	$ (16,682)
Adjustments to reconcile net loss to net cash from operating activities:
Depreciation and amortization	22,442	23,977	20,712
Non-cash compensation	12,344	10,711	6,912
Non-cash lease expense	7,432	7,521	7,145
Write-down of inventories and deferred preservation costs	4,374	5,377	3,443
Non-cash interest expense	1,832	2,005	3,656
Write-off of Endospan Option	0	4,944	0
Change in fair value of long-term loan receivable	0	409	4,949
Gain from sale of non-financial assets	0	(15,923)	0
Deferred income taxes	(1,717)	(4,470)	4,283
Change in fair value of contingent consideration	(9,000)	8,870	4,523
Other	2,268	2,060	124
Changes in operating assets and liabilities:
Accounts payable, accrued expenses, and other liabilities	(1,958)	(1,893)	(9,157)
Prepaid expenses and other assets	(2,234)	(1,404)	(2,720)
Inventories and deferred preservation costs	(8,404)	(18,375)	(24,757)
Receivables	(13,340)	(11,560)	9,938
Net cash flows (used in) provided by operating activities	(5,153)	(2,585)	12,369
Net cash flows from investing activities:
Proceeds from sale of non-financial assets, net	0	19,000	0
Payments for Endospan agreement	0	0	(5,000)
Ascyrus Acquisition, net of cash acquired	0	0	(59,119)
Acquisition of intangible assets	(1,699)	(972)	(1,157)
Capital expenditures	(9,016)	(13,091)	(7,328)
Other	0	723	(524)
Net cash flows (used in) provided by investing activities	(10,715)	5,660	(73,128)
Net cash flows from financing activities:
Proceeds from exercise of stock options and issuance of common stock	3,368	3,756	2,432
Proceeds from issuance of convertible debt	0	0	100,000
Proceeds from revolving line of credit	0	0	30,000
Proceeds from financing insurance premiums	0	0	2,815
Repayment of revolving line of credit	0	0	(30,000)
Payment of debt issuance costs	0	(2,219)	(3,647)
Payment of contingent consideration	0	(8,200)	0
Redemption and repurchase of stock to cover tax withholdings	(1,795)	(1,914)	(1,995)
Repayment of debt	(2,753)	(3,085)	(5,346)
Other	(459)	(561)	(651)
Net cash flows (used in) provided by financing activities	(1,639)	(12,223)	93,608
Effect of exchange rate changes on cash and cash equivalents	1,848	2,200	(5,185)
(Decrease) increase in cash and cash equivalents	(15,659)	(6,948)	27,664
Cash and cash equivalents, beginning of year	55,010	61,958	34,294
Cash and cash equivalents, end of year	$ 39,351	$ 55,010	$ 61,958