TransMedics (TMDX) 10-Q 5 May 22 2022 Q1 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - shares	3 Months Ended
	Mar. 31, 2022	Apr. 29, 2022
Cover [Abstract]
Document Type	10-Q
Amendment Flag	false
Document Period End Date	Mar. 31, 2022
Document Fiscal Year Focus	2022
Document Fiscal Period Focus	Q1
Entity Registrant Name	TransMedics Group, Inc.
Entity Central Index Key	0001756262
Current Fiscal Year End Date	--12-31
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Large Accelerated Filer
Entity Shell Company	false
Entity Emerging Growth Company	false
Entity Small Business	false
Entity Common Stock, Shares Outstanding		27,980,839
Entity File Number	001-38891
Entity Incorporation, State or Country Code	MA
Entity Tax Identification Number	83-2181531
Entity Address, Address Line One	200 Minuteman Road
Entity Address, City or Town	Andover
Entity Address, State or Province	MA
Entity Address, Postal Zip Code	01810
City Area Code	978
Local Phone Number	552-0900
Document Quarterly Report	true
Document Transition Report	false
Title of 12(b) Security	Common Stock, No Par Value
Trading Symbol	TMDX
Security Exchange Name	NASDAQ

CONSOLIDATED BALANCE SHEETS

CONSOLIDATED BALANCE SHEETS - USD ($) $ in Thousands	Mar. 31, 2022	Dec. 31, 2021
Current assets:
Cash and cash equivalents	$ 17,897	$ 25,580
Marketable securities	54,104	66,872
Accounts receivable	11,724	5,934
Inventory	16,714	14,859
Prepaid expenses and other current assets	5,356	5,460
Total current assets	105,795	118,705
Property and equipment, net	12,044	9,841
Restricted cash	500	500
Operating lease right-of-use assets	5,669	5,847
Total assets	124,008	134,893
Current liabilities:
Accounts payable	2,934	6,651
Accrued expenses and other current liabilities	15,738	16,337
Deferred revenue	247	250
Operating lease liabilities	1,337
Total current liabilities	20,256	23,238
Long-term debt, net of discount and current portion	35,334	35,197
Operating lease liabilities, net of current portion	8,508	8,604
Total liabilities	64,098	67,039
Commitments and contingencies (Note 9)
Stockholders' equity:
Preferred stock, no par value; 25,000,000 shares authorized; no shares issued or outstanding
Common stock, no par value; 150,000,000 shares authorized; 27,968,583 shares and 27,791,615 shares issued and outstanding at March 31, 2022 and December 31, 2021, respectively	513,203	510,488
Accumulated other comprehensive loss	(285)	(188)
Accumulated deficit	(453,008)	(442,446)
Total stockholders' equity	59,910	67,854
Total liabilities and stockholders' equity	$ 124,008	$ 134,893

CONSOLIDATED BALANCE SHEETS (Pa

CONSOLIDATED BALANCE SHEETS (Parenthetical) - $ / shares	Mar. 31, 2022	Dec. 31, 2021
Statement Of Financial Position [Abstract]
Preferred Stock, No Par Value
Preferred Stock, Shares Authorized	25,000,000	25,000,000
Preferred Stock, Shares Issued	0	0
Preferred Stock, Shares Outstanding	0	0
Common Stock, No Par Value
Common Stock, Shares Authorized	150,000,000	150,000,000
Common Stock, Shares, Issued	27,968,583	27,791,615
Common Stock, Shares, Outstanding	27,968,583	27,791,615

CONSOLIDATED STATEMENTS OF OPER

CONSOLIDATED STATEMENTS OF OPERATIONS - USD ($) $ in Thousands		3 Months Ended
		Mar. 31, 2022	Mar. 31, 2021
Income Statement [Abstract]
Net revenue	[1]	$ 15,880	$ 7,053
Cost of revenue		3,776	2,242
Gross profit		12,104	4,811
Operating expenses:
Research, development and clinical trials		7,534	4,532
Selling, general and administrative		13,939	6,786
Total operating expenses		21,473	11,318
Loss from operations		(9,369)	(6,507)
Other income (expense):
Interest expense		(960)	(952)
Other expense, net		(227)	(454)
Total other expense, net		(1,187)	(1,406)
Loss before income taxes		(10,556)	(7,913)
Provision for income taxes		(6)	(4)
Net loss		$ (10,562)	$ (7,917)
Net loss per share attributable to common stockholders, basic		$ (0.38)	$ (0.29)
Net loss per share attributable to common stockholders, diluted		$ (0.38)	$ (0.29)
Weighted average common shares outstanding, basic		27,950,330	27,368,090
Weighted average common shares outstanding, diluted		27,950,330	27,368,090
[1]	Net revenue by country is categorized based on the location of the end customer.

CONSOLIDATED STATEMENTS OF COMP

CONSOLIDATED STATEMENTS OF COMPREHENSIVE LOSS - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Statement Of Income And Comprehensive Income [Abstract]
Net loss	$ (10,562)	$ (7,917)
Other comprehensive income (loss):
Foreign currency translation adjustment	(24)	(2)
Unrealized gains (losses) on marketable securities, net of tax of $0	(73)	8
Total other comprehensive income (loss)	(97)	6
Comprehensive loss	$ (10,659)	$ (7,911)

CONSOLIDATED STATEMENTS OF CO_2

CONSOLIDATED STATEMENTS OF COMPREHENSIVE LOSS (Parenthetical) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Statement Of Income And Comprehensive Income [Abstract]
Other Comprehensive Income (Loss), Securities, Available-for-Sale, Unrealized Holding Gain (Loss) Arising During Period, Tax	$ 0	$ 0

CONSOLIDATED STATEMENTS OF STOC

CONSOLIDATED STATEMENTS OF STOCKHOLDERS' EQUITY - USD ($) $ in Thousands	Total	Common Stock	Accumulated Other Comprehensive Loss	Accumulated Deficit
Balance at Dec. 31, 2020	$ 103,891	$ 502,217	$ (95)	$ (398,231)
Balance, Shares at Dec. 31, 2020		27,175,305
Issuance of common stock upon the exercise of common stock options	372	$ 372
Issuance of common stock upon the exercise of common stock options, Shares		287,705
Issuance of common stock in connection with employee stock purchase plan	211	$ 211
Issuance of common stock in connection with employee stock purchase plan , Shares		14,951
Stock-based compensation expense	1,112	$ 1,112
Foreign currency translation adjustment	(2)		(2)
Unrealized gains (losses) on marketable securities	8		8
Net loss	(7,917)			(7,917)
Balance at Mar. 31, 2021	97,675	$ 503,912	(89)	(406,148)
Balance, Shares at Mar. 31, 2021		27,477,961
Balance at Dec. 31, 2020	103,891	$ 502,217	(95)	(398,231)
Balance, Shares at Dec. 31, 2020		27,175,305
Net loss	(44,200)
Balance at Dec. 31, 2021	67,854	$ 510,488	(188)	(442,446)
Balance, Shares at Dec. 31, 2021		27,791,615
Issuance of common stock upon the exercise of common stock options	202	$ 202
Issuance of common stock upon the exercise of common stock options, Shares		164,503
Issuance of common stock in connection with employee stock purchase plan	203	$ 203
Issuance of common stock in connection with employee stock purchase plan , Shares		12,465
Stock-based compensation expense	2,310	$ 2,310
Foreign currency translation adjustment	(24)		(24)
Unrealized gains (losses) on marketable securities	(73)		(73)
Net loss	(10,562)			(10,562)
Balance at Mar. 31, 2022	$ 59,910	$ 513,203	$ (285)	$ (453,008)
Balance, Shares at Mar. 31, 2022		27,968,583

CONSOLIDATED STATEMENTS OF CASH

CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Cash flows from operating activities:
Net loss	$ (10,562)	$ (7,917)
Adjustments to reconcile net loss to net cash used in operating activities:
Depreciation and amortization expense	507	445
Stock-based compensation expense	2,310	1,112
Non-cash interest expense and end of term accretion expense	137	130
Non-cash lease expense	178
Net amortization of premiums on marketable securities	228	391
Unrealized foreign currency transaction losses	214	484
Changes in operating assets and liabilities:
Accounts receivable	(5,804)	(583)
Inventory	(2,926)	(381)
Prepaid expenses and other current assets	88	(908)
Accounts payable	(4,013)	(82)
Accrued expenses and other current liabilities	(4)	(180)
Deferred revenue		182
Operating lease liabilities	1,241
Deferred rent		(23)
Net cash used in operating activities	(18,406)	(7,330)
Cash flows from investing activities:
Purchases of property and equipment	(1,953)	(20)
Purchases of marketable securities	(2,033)	(11,708)
Proceeds from sales and maturities of marketable securities	14,500	21,000
Net cash provided by investing activities	10,514	9,272
Cash flows from financing activities:
Proceeds from issuance of common stock upon exercise of stock options	202	372
Proceeds from issuance of common stock in connection with employee stock purchase plan	203	211
Net cash provided by financing activities	405	583
Effect of exchange rate changes on cash, cash equivalents and restricted cash	(196)	(379)
Net increase (decrease) in cash, cash equivalents and restricted cash	(7,683)	2,146
Cash, cash equivalents and restricted cash, beginning of period	26,080	25,081
Cash, cash equivalents and restricted cash, end of period	18,397	27,227
Supplemental disclosure of non-cash investing and financing activities:
Transfers of inventory to property and equipment	1,030	429
Purchases of property and equipment included in accounts payable and accrued expenses	939	7
Reconciliation of cash, cash equivalents and restricted cash:
Cash and cash equivalents	17,897	26,727
Restricted cash	500	500
Total cash, cash equivalents and restricted cash shown in the statement of cash flows	$ 18,397	$ 27,227

Nature of the Business and Basi

Nature of the Business and Basis of Presentation	3 Months Ended
	Mar. 31, 2022
Accounting Policies [Abstract]
Nature of the Business and Basis of Presentation	1. Nature of the Business and Basis of Presentation TransMedics Group, Inc. (“TransMedics Group” and, together with its consolidated subsidiaries, the “Company”) was incorporated in the Commonwealth of Massachusetts in October 2018. TransMedics, Inc. (“TransMedics”), an operating company and wholly owned subsidiary of TransMedics Group, was incorporated in the State of Delaware in August 1998. The Company is a commercial-stage medical technology company transforming organ transplant therapy for end-stage organ failure patients across multiple disease states. The Company developed the Organ Care System (“OCS”) to replace a decades-old standard of care. The OCS represents a paradigm shift that transforms organ preservation for transplantation from a static state to a dynamic environment that enables new capabilities, including organ optimization and assessment. The Company’s OCS technology replicates many aspects of the organ’s natural living and functioning environment outside of the human body. The accompanying consolidated financial statements have been prepared on the basis of continuity of operations, realization of assets and the satisfaction of liabilities and commitments in the ordinary course of business. The Company has incurred recurring losses since inception, including net losses of $10.6 million for the three months ended March 31, 2022 and $44.2 million for the year ended December 31, 2021. As of March 31, 2022, the Company had an accumulated deficit of $453.0 million. The Company expects to continue to generate operating losses in the foreseeable future. The Company believes that its existing cash, cash equivalents, and marketable securities of $72.0 million as of March 31, 2022 will be sufficient to fund its operations, capital expenditures, and debt service payments for at least the next 12 months following the filing of this Quarterly Report on Form 10-Q. The Company may need to seek additional funding through equity financings, debt financings or strategic alliances. The Company may not be able to obtain financing on acceptable terms, or at all, and the terms of any financing may adversely affect the holdings or the rights of the Company’s shareholders. If the Company is unable to obtain funding, the Company will be required to delay, reduce or eliminate some or all of its research and development programs, product expansion or commercialization efforts, or the Company may be unable to continue operations. The Company is subject to risks and uncertainties common to companies in the medical device industry and of similar size, including, but not limited to, development by competitors of new technological innovations, dependence on key personnel, protection of proprietary technology, compliance with government regulations, uncertainty of market acceptance of products, and the need to obtain additional financing to fund operations. Potential risks and uncertainties also include, without limitation, uncertainties regarding the duration and magnitude of the impact of the COVID-19 pandemic on the Company’s business and the economy generally. Products currently under development will require additional research and development efforts, including additional clinical testing and regulatory approval, prior to commercialization. These efforts require additional capital, adequate personnel, infrastructure and extensive compliance-reporting capabilities. The Company’s research and development may not be successfully completed, adequate protection for the Company’s technology may not be obtained, the Company may not obtain necessary government regulatory approval on its expected timeline or at all, and approved products may not prove commercially viable. The Company operates in an environment of rapid change in technology and competition. The impact of the COVID-19 pandemic has been and may continue to be extensive in many aspects of society, which has resulted in and may continue to result in significant disruptions to the global economy, as well as businesses and capital markets around the world. Impacts to the Company’s business as a result of COVID-19 have included the temporary disruption of transplant procedures at many of the organ transplant centers that purchase OCS products; customer delays or reductions in customer capital expenditures and operating budgets and the related impact on its product sales; disruptions to the Company’s manufacturing operations and supply chain caused by facility closures, reductions in operating hours, staggered shifts and other social distancing efforts; labor shortages; decreased productivity and unavailability of materials or components; delays of reviews and approvals by the Food and Drug Administration (“FDA”) and other health authorities; delays in the Company’s clinical trial enrollment; limitations on its employees’ and customers’ ability to travel, and delays in product installations, trainings or shipments to and from other affected countries and within the United States. In response to the pandemic, healthcare providers have, and may need to further, reallocate resources, such as physicians, staff, hospital beds and intensive care unit facilities, and these actions significantly delay the provision of other medical care such as organ transplantation and reduce the number of transplant procedures that are performed, which negatively impacts the Company’s revenue and cash flows. While the Company maintains an inventory of finished products and raw materials used in its OCS products, a prolonged pandemic could lead to shortages in the raw materials necessary to manufacture its products. The COVID-19 pandemic also has impacted operations at the FDA and other health authorities, resulting in delays of reviews and approvals, and may affect other potential Pre-Market Approval (“PMA”) applications. The Company’s consolidated financial statements have been prepared in conformity with accounting principles generally accepted in the United States of America (“GAAP”). Any reference in these notes to applicable guidance is meant to refer to the authoritative GAAP as found in the Accounting Standards Codification (“ASC”) and Accounting Standards Update (“ASU”) of the Financial Accounting Standards Board (“FASB”).

Summary of Significant Accounti

Summary of Significant Accounting Policies	3 Months Ended
	Mar. 31, 2022
Accounting Policies [Abstract]
Summary of Significant Accounting Policies	2. Summary of Significant Accounting Policies Unaudited Interim Financial Information The accompanying unaudited interim financial statements and related notes have been prepared by the Company pursuant to the rules and regulations of the Securities and Exchange Commission (“SEC”) for interim financial statements. Certain information and footnote disclosures normally included in the financial statements prepared in accordance with GAAP have been condensed or omitted pursuant to such rules and regulations. These consolidated financial statements should be read in conjunction with the Company’s audited consolidated financial statements and the notes thereto for the year ended December 31, 2021 included in the Company’s Annual Report on Form 10-K filed with the SEC. In the opinion of management, all adjustments, consisting only of normal recurring adjustments necessary for a fair statement of the Company’s financial position as of March 31, 2022 and results of operations for the three months ended March 31, 2022 and 2021 and cash flows for the three months ended March 31, 2022 and 2021 have been made. The Company’s results of operations for the three months ended March 31, 2022 are not necessarily indicative of the results of operations that may be expected for the year ending December 31, 2022. Use of Estimates The preparation of financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities, the disclosure of contingent assets and liabilities at the date of the financial statements, and the reported amounts of revenue and expenses during the reporting periods. Significant estimates and assumptions reflected in these consolidated financial statements include, but are not limited to, revenue recognition, the valuation of inventory and the valuation of stock-based awards. The Company bases its estimates on historical experience, known trends and other market-specific or other relevant factors that it believes to be reasonable under the circumstances. On an ongoing basis, management evaluates its estimates as there are changes in circumstances, facts and experience. Changes in estimates are recorded in the period in which they become known. The full extent to which the COVID-19 pandemic will directly or indirectly impact the Company’s business, results of operations and financial condition, including sales, expenses, reserves and allowances, manufacturing, clinical trials, research and development costs and employee-related amounts, will depend on future developments that are highly uncertain, including as a result of new information that may emerge concerning COVID-19 and the actions taken to contain or treat COVID-19, as well as the economic impact on local, regional, national and international customers and markets. The Company has made estimates of the impact of COVID-19 within its financial statements and there may be changes to those estimates in future periods. Risk of Concentrations of Credit, Significant Customers and Significant Suppliers Financial instruments that potentially expose the Company to concentrations of credit risk consist primarily of cash, cash equivalents, marketable securities, and accounts receivable. The Company does not believe that it is subject to unusual credit risk beyond the normal credit risk associated with commercial banking relationships. As of March 31, 2022 and December 31, 2021, the Company had no allowance for credit losses. Significant customers are those that accounted for 10% or more of the Company’s net revenue or accounts receivable. For the three months ended March 31, 2022, three customers accounted for %, 15% and 12% of net revenue, respectively. For the three months ended March 3 1 , 202 1 , two customer s each accounted for % of net revenue. As of March 31, 2022 , four customer s accounted for 14 % , 12 %, 12 % and 10 % of accounts receivable , respectively . As of December 31 , 20 2 1 , two customer s accounted for 21 % and 15 % of accounts receivable , respectively . Certain of the components and subassemblies included in the Company’s products are obtained from a sole source, a single source or a limited group of suppliers. Although the Company seeks to reduce dependence on those limited sources of suppliers and manufacturers, the partial or complete loss of certain of these sources could have a material adverse effect on the Company’s operating results, financial condition and cash flows and damage its customer relationships. Fair Value Measurements Certain assets and liabilities are carried at fair value under GAAP. Fair value is defined as the exchange price that would be received for an asset or paid to transfer a liability (an exit price) in the principal or most advantageous market for the asset or liability in an orderly transaction between market participants on the measurement date. Valuation techniques used to measure fair value must maximize the use of observable inputs and minimize the use of unobservable inputs. Financial assets and liabilities carried at fair value are to be classified and disclosed in one of the following three levels of the fair value hierarchy, of which the first two are considered observable and the last is considered unobservable: • Level 1—Quoted prices in active markets for identical assets or liabilities. • Level 2—Observable inputs (other than Level 1 quoted prices), such as quoted prices in active markets for similar assets or liabilities, quoted prices in markets that are not active for identical or similar assets or liabilities, or other inputs that are observable or can be corroborated by observable market data. • Level 3—Unobservable inputs that are supported by little or no market activity and that are significant to determining the fair value of the assets or liabilities, including pricing models, discounted cash flow methodologies and similar techniques. The Company’s cash equivalents and marketable securities are carried at fair value, determined according to the fair value hierarchy described above (see Note 4). The carrying values of the Company’s accounts receivable, accounts payable and accrued expenses approximate their fair values due to the short-term nature of these assets and liabilities. The carrying value of the Company’s long-term debt approximates its fair value (a level 2 measurement) at each balance sheet date due to its variable interest rate, which approximates a market interest rate. Segment Information The Company manages its operations as a single Net Income (Loss) per Share Basic net income (loss) per common share is computed by dividing the net income (loss) by the weighted average number of shares of common stock outstanding for the period. Diluted net income (loss) per common share is computed by dividing net income (loss) by the weighted average number of shares of common stock outstanding for the period, including potential dilutive common shares assuming the dilutive effect of outstanding stock awards. For periods in which the Company reports a net loss, diluted net loss per common share is the same as basic net loss per common share, since dilutive common shares are not assumed to have been issued if their effect is anti-dilutive. The Company reported a net loss attributable to common stockholders for each of the three months ended March 31, 2022 and 2021. The Company’s potential dilutive securities have been excluded from the computation of diluted net loss per share as the effect would be to reduce the net loss per share. The Company excluded the following potential common shares, presented based on amounts outstanding at each period end, from the computation of diluted net loss per share attributable to common stockholders for the periods indicated above because including them would have had an anti-dilutive effect: As of March 31, 2022 2021 Warrants to purchase common stock 64,440 64,440 Options to purchase common stock 3,484,914 2,764,876 Employee stock purchase plan 5,794 5,882 3,555,148 2,835,198

Marketable Securities

Marketable Securities	3 Months Ended
	Mar. 31, 2022
Investments Debt And Equity Securities [Abstract]
Marketable Securities	3. Marketable Securities Marketable securities by security type consisted of the following (in thousands): March 31, 2022 Amortized Cost Gross Unrealized Gains Gross Unrealized Losses Fair Value U.S. Treasury securities (due within one year) $ 51,212 $ — $ (102 ) $ 51,110 U.S. government agency bonds (due within one year) 3,001 — (7 ) 2,994 $ 54,213 $ — $ (109 ) $ 54,104 December 31, 2021 Amortized Cost Gross Unrealized Gains Gross Unrealized Losses Fair Value U.S. Treasury securities (due within one year) $ 63,907 $ — $ (33 ) $ 63,874 U.S. government agency bonds (due within one year) 3,001 — (3 ) 2,998 $ 66,908 $ — $ (36 ) $ 66,872

Fair Value of Financial Assets

Fair Value of Financial Assets and Liabilities	3 Months Ended
	Mar. 31, 2022
Fair Value Disclosures [Abstract]
Fair Value of Financial Assets and Liabilities	4. Fair Value of Financial Assets and Liabilities The following tables present the Company’s fair value hierarchy for its assets and liabilities that are measured at fair value on a recurring basis (in thousands): Fair Value Measurements at March 31, 2022 Using: Level 1 Level 2 Level 3 Total Assets: Cash equivalents: Money market funds $ 2,847 $ — $ — $ 2,847 Marketable securities: U.S. Treasury securities — 51,110 — 51,110 U.S. government agency bonds — 2,994 — 2,994 $ 2,847 $ 54,104 $ — $ 56,951 Fair Value Measurements at December 31, 2021 Using: Level 1 Level 2 Level 3 Total Assets: Cash equivalents: Money market funds $ 11,169 $ — $ — $ 11,169 Marketable securities: U.S. Treasury securities — 63,874 — 63,874 U.S. government agency bonds — 2,998 — 2,998 $ 11,169 $ 66,872 $ — $ 78,041 Money market funds were valued by the Company based on quoted market prices, which represent a Level 1 measurement within the fair value hierarchy. U.S. Treasury securities and U.S. government agency bonds were valued by the Company using quoted prices in active markets for similar securities, which represent a Level 2 measurement within the fair value hierarchy.

Inventory

Inventory	3 Months Ended
	Mar. 31, 2022
Inventory Disclosure [Abstract]
Inventory	5. Inventory Inventory consisted of the following (in thousands): March 31, 2022 December 31, 2021 Raw materials $ 8,322 $ 7,274 Work-in-process 2,501 1,932 Finished goods 5,891 5,653 $ 16,714 $ 14,859 During the three months ended March 31, 2022 and 2021, the Company made non-cash transfers of OCS Consoles from inventory to property and equipment (OCS Consoles loaned to customers) of $1.0 million and $0.4 million, respectively.

Accrued Expenses and Other Curr

Accrued Expenses and Other Current Liabilities	3 Months Ended
	Mar. 31, 2022
Accrued Expenses And Other Current Liabilities [Abstract]
Accrued Expenses and Other Current Liabilities	6. Accrued Expenses and Other Current Liabilities Accrued expenses and other current liabilities consisted of the following (in thousands): March 31, 2022 December 31, 2021 Accrued research, development and clinical trials expenses $ 4,532 $ 4,567 Accrued payroll and related expenses 5,819 5,173 Accrued professional fees 857 1,973 Accrued other 4,530 4,624 $ 15,738 $ 16,337

Long-Term Debt

Long-Term Debt	3 Months Ended
	Mar. 31, 2022
Debt Disclosure [Abstract]
Long-Term Debt	7. Long-Term Debt TransMedics has a credit agreement (the “Credit Agreement”) with OrbiMed Royalty Opportunities II, LP (“OrbiMed”), entered into in June 2018, pursuant to which TransMedics borrowed $35.0 million. Long-term debt consisted of the following (in thousands): March 31, 2022 December 31, 2021 Principal amount of long-term debt $ 35,000 $ 35,000 Less: Current portion of long-term debt — — Long-term debt, net of current portion 35,000 35,000 Debt discount, net of accretion (428 ) (511 ) Accrued end-of-term payment 762 708 Long-term debt, net of discount and current portion $ 35,334 $ 35,197 Borrowings under the Credit Agreement bear interest at an annual rate equal to the London Interbank Offered Rate (“LIBOR”), subject to a minimum of 1.0% and a maximum of 4.0%, plus 8.5% (the “Applicable Margin”), subject in the aggregate to a maximum interest rate of 11.5%. In addition, borrowings under the Credit Agreement bear paid-in-kind (“PIK”) interest at an annual rate equal to the amount by which LIBOR plus the Applicable Margin exceeds 11.5%, but not to exceed 12.5%. The PIK interest is added to the principal amount of the borrowings outstanding at the end of each quarter until the maturity date of the Credit Agreement in June 2023. Borrowings under the Credit Agreement are repayable in quarterly interest-only payments until the maturity date, at which time all principal and accrued interest is due and payable. At its option, the company may prepay outstanding borrowings under the Credit Agreement. The Company is required to make a final payment in an amount equal to 3.0% of the principal amount of any prepayment or repayment. The final payment and debt discount amounts are being accreted to interest expense over the term of the Credit Agreement using the effective interest method. All obligations under the Credit Agreement are guaranteed by the Company and each of its material subsidiaries. All obligations of the Company and each guarantor are secured by substantially all of the Company’s and each guarantor’s assets, including their intellectual property, subject to certain exceptions, including a perfected security interest in substantially all tangible and intangible assets of the Company and each guarantor. Under the Credit Agreement, the Company has agreed to certain affirmative and negative covenants to which it will remain subject until maturity. The financial covenants include maintaining a minimum liquidity amount of $3.0 million; the requirement, on an annual basis, to deliver to OrbiMed annual audited financial statements with an unqualified audit opinion from the Company’s independent registered public accounting firm; and restrictions on the Company’s activities, including limitations on dispositions, mergers or acquisitions; encumbering its intellectual property; incurring indebtedness or liens; paying dividends; making certain investments; and engaging in certain other business transactions. As of March 31, 2022, the Company was in compliance with the financial covenants under the Credit Agreement. The obligations under the Credit Agreement are subject to acceleration upon the occurrence of specified events of default, including payment default, change in control, bankruptcy, insolvency, certain defaults under other material debt, certain events with respect to governmental approvals (if such events could cause a material adverse change in the Company’s business), failure to comply with certain covenants, including the minimum liquidity and unqualified audit opinion covenants, and a material adverse change in the Company’s business, operations or other financial condition. Upon the occurrence of an event of default and until such event of default is no longer continuing, the Applicable Margin will increase by 4.0% per annum. If an event of default (other than certain events of bankruptcy or insolvency) occurs and is continuing, OrbiMed may declare all or any portion of the outstanding principal amount of the borrowings plus accrued and unpaid interest to be due and payable. Upon the occurrence of certain events of bankruptcy or insolvency, all of the outstanding principal amount of the borrowings plus accrued and unpaid interest will automatically become due and payable. In addition, the Company may be required to prepay outstanding borrowings, subject to certain exceptions, with portions of net cash proceeds of certain asset sales and certain casualty and condemnation events. As of March 31, 2022, the interest rate applicable to borrowings under the Credit Agreement was 9.5%. During the three months ended March 31, 2022, the weighted average effective interest rate on outstanding borrowings under the Credit Agreement was approximately 11.2%.

Stock-Based Compensation

Stock-Based Compensation	3 Months Ended
	Mar. 31, 2022
Stockholders Equity Note [Abstract]
Stock-Based Compensation	8. Stock-Based Compensation 2019 Stock Incentive Plan The Company’s 2019 Stock Incentive Plan (the “2019 Plan”) provides for the grant of incentive stock options, nonqualified stock options, stock appreciation rights, restricted stock, restricted stock units, unrestricted stock, unrestricted stock units, and other stock-based awards to employees, directors, and consultants of the Company and its subsidiaries. The number of shares of common stock of TransMedics Group initially available for issuance under the 2019 Plan was 3,428,571 shares, plus the number of shares underlying awards under the previously outstanding 2014 Stock Incentive Plan (the “2014 Plan”), not to exceed 1,595,189 shares, that expire or are terminated, surrendered, or cancelled without the delivery of shares, are forfeited to or repurchased by TransMedics Group or otherwise become available again for grant. Since the effectiveness of the Company’s 2019 Plan in April 2019, no future awards will be made under the 2014 Plan. Shares withheld in payment of the exercise or purchase price of an award or in satisfaction of tax withholding requirements, and the shares covered by a stock appreciation right for which any portion is settled in stock, will reduce the number of shares available for issuance under the 2019 Plan. In addition, the number of shares available for issuance under the 2019 Plan (i) will not be increased by any shares delivered under the 2019 Plan that are subsequently repurchased using proceeds directly attributable to stock option exercises and (ii) will not be reduced by any awards that are settled in cash or that expire, become unexercisable, terminate or are forfeited to or repurchased by TransMedics Group without the issuance of stock under the 2019 Plan. As of March 31, 2022, 890,558 shares of common stock were available for issuance under the 2019 Plan. 2019 Employee Stock Purchase Plan Pursuant to the Company’s 2019 Employee Stock Purchase Plan (the “2019 ESPP”), certain employees of the Company are eligible to purchase common stock of the Company at a reduced price during offering periods. The 2019 ESPP permits participants to purchase common stock using funds contributed through payroll deductions, subject to the limitations set forth in the Internal Revenue Code, at a purchase price of 85% of the lower of the closing price of the Company’s common stock on the first trading day of the offering period or the closing price on the applicable purchase date, which is the final trading day of the applicable offering period. A total of 371,142 shares of the Company’s common stock are reserved for issuance under the 2019 ESPP. During the three months ended March 31, 2022, 12,465 shares of common stock were issued under the 2019 ESPP and as of March 31, 2022, 308,131 shares of common stock remained available for issuance. 2021 Inducement Plan In August 2021, the Company’s board of directors approved the TransMedics Group, Inc. Inducement Plan (the “Inducement Plan”). Pursuant to the terms of the Inducement Plan, the Company may grant nonstatutory stock options, stock appreciation rights, restricted stock, unrestricted stock, restricted stock unit awards and performance awards to individuals who were not previously employees or directors of the Company or individuals returning to employment after a bona fide period of non-employment with the Company. A total of 1,000,000 shares of the Company’s common stock were initially available for issuance under the Inducement Plan. As of March 31, 2022, 580,200 shares of common stock were available for issuance under the Inducement Plan. Stock-Based Compensation The Company recorded stock-based compensation expense in the following expense categories of its consolidated statements of operations (in thousands): Three Months Ended March 31, 2022 2021 Cost of revenue $ 25 $ 13 Research, development and clinical trials expenses 321 197 Selling, general and administrative expenses 1,964 902 $ 2,310 $ 1,112 During the three months ended March 31, 2022, the Company granted options to its employees and directors with service-based vesting for the purchase of an aggregate of 880,910 shares of common stock with a weighted average grant-date fair value of $7.11 per share. As of March 31, 2022, total unrecognized compensation cost related to unvested share-based awards was $24.6 million, which is expected to be recognized over a weighted average period of 3.1 years.

Commitments and Contingencies

Commitments and Contingencies	3 Months Ended
	Mar. 31, 2022
Commitments And Contingencies Disclosure [Abstract]
Commitments and Contingencies	9. Commitments and Contingencies Operating Leases The Company leases office, laboratory and manufacturing space under two non-cancelable Leases, License Agreement with the Department of Veterans Affairs In 2002, the Company entered into a license agreement with the Department of Veterans Affairs (the “VA”), under which the Company was granted an exclusive, worldwide license under specified patents to make, use, sell and import certain technology used in the Company’s products and a non-exclusive, worldwide license to make, use, sell and import solutions for use in or with those products. The rights under the license agreement continue until the expiration of the last to expire of the licensed patents. The majority of the licensed U.S. patents expired in 2017, and the foreign patents expired in September 2018. However, the Company has requested a patent term extension for one U.S. patent covered by the VA license agreement, U.S. Patent No. 6100082. The Company was granted an interim patent term extension for this patent until November 6, 2021. The Company has not received final approval of the patent extension beyond the interim patent term extension already granted. The maximum extension requested would be through May 2022; however, the length of the patent term extension will be determined by the United States Patent and Trademark Office (“USPTO”) based on input from the FDA. . As consideration for the licenses granted by the VA, the Company is obligated to pay tiered royalties ranging from a low single-digit to a mid single-digit percentage on net sales of each product covered by a licensed patent (subject to a minimum aggregate royalty payment of less than $0.1 million per year during each of the first five years after the first commercial sale, after which no minimum is required). Royalties will be paid by the Company on a licensed product-by-licensed product and country-by-country basis, beginning on the first commercial sale of such licensed product in such country until expiration of the last valid patent claim covering such licensed product in such country. The Company is also responsible for all costs related to the amendment, prosecution and maintenance of the licensed patent rights. The VA license agreement can be terminated by the Company or the VA only if the other party fails to cure its material breach within a specified period after receiving notice of such breach. 401(k) Savings Plan The Company has a defined-contribution savings plan under Section 401(k) of the Internal Revenue Code. This plan covers substantially all employees who meet minimum age and service requirements and allows participants to defer a portion of their annual compensation on a pre-tax basis. Company contributions to the plan may be made at the discretion of the board of directors. As of March 31, 2022 and December 31, 2021, the Company had not made any contributions to the plan. Indemnification Agreements In the ordinary course of business, the Company has agreed to defend and indemnify its customers against third-party claims asserting infringement of certain intellectual property rights, which may include patents, copyrights, trademarks, or trade secrets. The Company’s exposure under these indemnification provisions is generally limited to the total amount paid by the end-customer under the agreement. However, certain agreements include indemnification provisions that could potentially expose the Company to losses in excess of the amount received under the agreement. In the ordinary course of business, the Company may provide indemnification of varying scope and terms to vendors, lessors, business partners, and other parties with respect to certain matters including, but not limited to, losses arising out of breach of such agreements or from intellectual property infringement claims made by third parties. In addition, the Company has entered into indemnification agreements with members of its board of directors that will require the Company, among other things, to indemnify them against certain liabilities that may arise by reason of their status or services as directors or officers. The maximum potential amount of future payments the Company could be required to make under these indemnification agreements is, in many cases, unlimited. To date, the Company has not incurred any material costs as a result of such indemnifications. The Company is not currently aware of any indemnification claims and had not accrued any liabilities related to such obligations in its consolidated financial statements as of March 31, 2022 and December 31, 2021. Unconditional Purchase Commitment In January 2021, the Company entered into an unconditional $9.5 million purchase commitment, in the ordinary course of business, for goods with specified annual minimum quantities to be purchased through December 2029. The contract is not cancellable without penalty. The remaining purchase commitment as of March 31, 2022 was $8.0 million. Legal Proceedings The Company is not currently party to any material legal proceedings. At each reporting date, the Company evaluates whether or not a potential loss amount or a potential range of loss is probable and reasonably estimable under the provisions of the authoritative guidance that addresses accounting for contingencies. The Company expenses as incurred the costs related to such legal proceedings.

Segment Reporting and Geographi

Segment Reporting and Geographic Data	3 Months Ended
	Mar. 31, 2022
Segment Reporting [Abstract]
Segment Reporting and Geographic Data	10. Segment Reporting and Geographic Data The Company has determined that it operates in one segment (see Note 2). See Note 11 for revenue by country. Long-lived assets by geography are summarized as follows (in thousands): March 31, 2022 December 31, 2021 Long-lived assets by country(1): United States $ 11,317 $ 9,085 All other countries 727 756 Total long-lived assets $ 12,044 $ 9,841 ( 1 ) The Company’s only long-lived assets consist of property and equipment, net of depreciation, which are categorized based on their location of domicile.

Revenue

Revenue	3 Months Ended
	Mar. 31, 2022
Revenue From Contract With Customer [Abstract]
Revenue	11. 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 revenue to net revenue for these certain payments is shown below (in thousands): Three Months Ended March 31, 2022 2021 Gross revenue from sales to customers $ 15,880 $ 7,637 Less: clinical trial payments reducing revenue — 584 Total net revenue $ 15,880 $ 7,053 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 $0.5 million for each of the three months ended March 31, 2022 and 2021, as operating expenses. Disaggregated Revenue The Company disaggregates revenue from contracts with customers by product 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): Three Months Ended March 31, 2022 2021 Net revenue by OCS product: OCS Lung net revenue $ 2,298 $ 2,430 OCS Heart net revenue 5,713 4,181 OCS Liver net revenue 7,869 442 Total net revenue $ 15,880 $ 7,053 Three Months Ended March 31, 2022 2021 Net revenue by country(1): United States $ 13,561 $ 5,757 All other countries 2,319 1,296 Total net revenue $ 15,880 $ 7,053 (1) Net revenue by country is categorized based on the location of the end customer. Contract Assets and Liabilities The Company recognizes a receivable at the point in time at which it has an unconditional right to payment. Such receivables are not contract assets. Contract assets arise from unbilled amounts in customer arrangements when revenue recognized exceeds the amount billed to the customer and the Company’s right to payment is not just subject to the passage of time. The Company had no contract assets as of March 31, 2022 and December 31, 2021. Contract liabilities represent the Company’s obligation to transfer goods or services to a customer for which it has received consideration (or the amount is due) from the customer. The Company has determined that its only contract liabilities are deferred revenue, which consists of amounts that have been invoiced but that have not been recognized as revenue. The Company generally satisfies performance obligations within one year of the contract inception date. As of March 31, 2022, the Company’s wholly- or partially unsatisfied performance obligations totaled $2.1 million and are expected to be completed within the next year.

Related Party Transactions

Related Party Transactions	3 Months Ended
	Mar. 31, 2022
Related Party Transactions [Abstract]
Related Party Transactions	12. Related Party Transactions Employment of Dr. Amira Hassanein Dr. Amira Hassanein, who serves as Product Director for the Company’s OCS Lung program, is the sister of Dr. Waleed Hassanein, the Company’s President and Chief Executive Officer and a member of the Company’s board of directors. The Company paid Dr. Amira Hassanein approximately $0.1 million in total compensation for each of the three months ended March 31, 2022 and 2021 for her services as an employee.

Summary of Significant Accoun_2

Summary of Significant Accounting Policies (Policies)	3 Months Ended
	Mar. 31, 2022
Accounting Policies [Abstract]
Unaudited Interim Financial Information	Unaudited Interim Financial Information The accompanying unaudited interim financial statements and related notes have been prepared by the Company pursuant to the rules and regulations of the Securities and Exchange Commission (“SEC”) for interim financial statements. Certain information and footnote disclosures normally included in the financial statements prepared in accordance with GAAP have been condensed or omitted pursuant to such rules and regulations. These consolidated financial statements should be read in conjunction with the Company’s audited consolidated financial statements and the notes thereto for the year ended December 31, 2021 included in the Company’s Annual Report on Form 10-K filed with the SEC. In the opinion of management, all adjustments, consisting only of normal recurring adjustments necessary for a fair statement of the Company’s financial position as of March 31, 2022 and results of operations for the three months ended March 31, 2022 and 2021 and cash flows for the three months ended March 31, 2022 and 2021 have been made. The Company’s results of operations for the three months ended March 31, 2022 are not necessarily indicative of the results of operations that may be expected for the year ending December 31, 2022.
Use of Estimates	Use of Estimates The preparation of financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities, the disclosure of contingent assets and liabilities at the date of the financial statements, and the reported amounts of revenue and expenses during the reporting periods. Significant estimates and assumptions reflected in these consolidated financial statements include, but are not limited to, revenue recognition, the valuation of inventory and the valuation of stock-based awards. The Company bases its estimates on historical experience, known trends and other market-specific or other relevant factors that it believes to be reasonable under the circumstances. On an ongoing basis, management evaluates its estimates as there are changes in circumstances, facts and experience. Changes in estimates are recorded in the period in which they become known. The full extent to which the COVID-19 pandemic will directly or indirectly impact the Company’s business, results of operations and financial condition, including sales, expenses, reserves and allowances, manufacturing, clinical trials, research and development costs and employee-related amounts, will depend on future developments that are highly uncertain, including as a result of new information that may emerge concerning COVID-19 and the actions taken to contain or treat COVID-19, as well as the economic impact on local, regional, national and international customers and markets. The Company has made estimates of the impact of COVID-19 within its financial statements and there may be changes to those estimates in future periods.
Risk of Concentrations of Credit, Significant Customers and Significant Suppliers	Risk of Concentrations of Credit, Significant Customers and Significant Suppliers Financial instruments that potentially expose the Company to concentrations of credit risk consist primarily of cash, cash equivalents, marketable securities, and accounts receivable. The Company does not believe that it is subject to unusual credit risk beyond the normal credit risk associated with commercial banking relationships. As of March 31, 2022 and December 31, 2021, the Company had no allowance for credit losses. Significant customers are those that accounted for 10% or more of the Company’s net revenue or accounts receivable. For the three months ended March 31, 2022, three customers accounted for %, 15% and 12% of net revenue, respectively. For the three months ended March 3 1 , 202 1 , two customer s each accounted for % of net revenue. As of March 31, 2022 , four customer s accounted for 14 % , 12 %, 12 % and 10 % of accounts receivable , respectively . As of December 31 , 20 2 1 , two customer s accounted for 21 % and 15 % of accounts receivable , respectively . Certain of the components and subassemblies included in the Company’s products are obtained from a sole source, a single source or a limited group of suppliers. Although the Company seeks to reduce dependence on those limited sources of suppliers and manufacturers, the partial or complete loss of certain of these sources could have a material adverse effect on the Company’s operating results, financial condition and cash flows and damage its customer relationships.
Fair Value Measurements	Fair Value Measurements Certain assets and liabilities are carried at fair value under GAAP. Fair value is defined as the exchange price that would be received for an asset or paid to transfer a liability (an exit price) in the principal or most advantageous market for the asset or liability in an orderly transaction between market participants on the measurement date. Valuation techniques used to measure fair value must maximize the use of observable inputs and minimize the use of unobservable inputs. Financial assets and liabilities carried at fair value are to be classified and disclosed in one of the following three levels of the fair value hierarchy, of which the first two are considered observable and the last is considered unobservable: • Level 1—Quoted prices in active markets for identical assets or liabilities. • Level 2—Observable inputs (other than Level 1 quoted prices), such as quoted prices in active markets for similar assets or liabilities, quoted prices in markets that are not active for identical or similar assets or liabilities, or other inputs that are observable or can be corroborated by observable market data. • Level 3—Unobservable inputs that are supported by little or no market activity and that are significant to determining the fair value of the assets or liabilities, including pricing models, discounted cash flow methodologies and similar techniques. The Company’s cash equivalents and marketable securities are carried at fair value, determined according to the fair value hierarchy described above (see Note 4). The carrying values of the Company’s accounts receivable, accounts payable and accrued expenses approximate their fair values due to the short-term nature of these assets and liabilities. The carrying value of the Company’s long-term debt approximates its fair value (a level 2 measurement) at each balance sheet date due to its variable interest rate, which approximates a market interest rate.
Segment Information	Segment Information The Company manages its operations as a single
Net Income (Loss) per Share	Net Income (Loss) per Share Basic net income (loss) per common share is computed by dividing the net income (loss) by the weighted average number of shares of common stock outstanding for the period. Diluted net income (loss) per common share is computed by dividing net income (loss) by the weighted average number of shares of common stock outstanding for the period, including potential dilutive common shares assuming the dilutive effect of outstanding stock awards. For periods in which the Company reports a net loss, diluted net loss per common share is the same as basic net loss per common share, since dilutive common shares are not assumed to have been issued if their effect is anti-dilutive. The Company reported a net loss attributable to common stockholders for each of the three months ended March 31, 2022 and 2021. The Company’s potential dilutive securities have been excluded from the computation of diluted net loss per share as the effect would be to reduce the net loss per share. The Company excluded the following potential common shares, presented based on amounts outstanding at each period end, from the computation of diluted net loss per share attributable to common stockholders for the periods indicated above because including them would have had an anti-dilutive effect: As of March 31, 2022 2021 Warrants to purchase common stock 64,440 64,440 Options to purchase common stock 3,484,914 2,764,876 Employee stock purchase plan 5,794 5,882 3,555,148 2,835,198

Summary of Significant Accoun_3

Summary of Significant Accounting Policies (Tables)	3 Months Ended
	Mar. 31, 2022
Accounting Policies [Abstract]
Schedule of Antidilutive Securities Excluded from Computation of Earnings Per Share	The Company excluded the following potential common shares, presented based on amounts outstanding at each period end, from the computation of diluted net loss per share attributable to common stockholders for the periods indicated above because including them would have had an anti-dilutive effect: As of March 31, 2022 2021 Warrants to purchase common stock 64,440 64,440 Options to purchase common stock 3,484,914 2,764,876 Employee stock purchase plan 5,794 5,882 3,555,148 2,835,198

Marketable Securities (Tables)

Marketable Securities (Tables)	3 Months Ended
	Mar. 31, 2022
Investments Debt And Equity Securities [Abstract]
Components of Marketable Securities by Security Type	Marketable securities by security type consisted of the following (in thousands): March 31, 2022 Amortized Cost Gross Unrealized Gains Gross Unrealized Losses Fair Value U.S. Treasury securities (due within one year) $ 51,212 $ — $ (102 ) $ 51,110 U.S. government agency bonds (due within one year) 3,001 — (7 ) 2,994 $ 54,213 $ — $ (109 ) $ 54,104 December 31, 2021 Amortized Cost Gross Unrealized Gains Gross Unrealized Losses Fair Value U.S. Treasury securities (due within one year) $ 63,907 $ — $ (33 ) $ 63,874 U.S. government agency bonds (due within one year) 3,001 — (3 ) 2,998 $ 66,908 $ — $ (36 ) $ 66,872

Fair Value of Financial Asset_2

Fair Value of Financial Assets and Liabilities (Tables)	3 Months Ended
	Mar. 31, 2022
Fair Value Disclosures [Abstract]
Schedule of Fair Value, Assets and Liabilities Measured on Recurring Basis	The following tables present the Company’s fair value hierarchy for its assets and liabilities that are measured at fair value on a recurring basis (in thousands): Fair Value Measurements at March 31, 2022 Using: Level 1 Level 2 Level 3 Total Assets: Cash equivalents: Money market funds $ 2,847 $ — $ — $ 2,847 Marketable securities: U.S. Treasury securities — 51,110 — 51,110 U.S. government agency bonds — 2,994 — 2,994 $ 2,847 $ 54,104 $ — $ 56,951 Fair Value Measurements at December 31, 2021 Using: Level 1 Level 2 Level 3 Total Assets: Cash equivalents: Money market funds $ 11,169 $ — $ — $ 11,169 Marketable securities: U.S. Treasury securities — 63,874 — 63,874 U.S. government agency bonds — 2,998 — 2,998 $ 11,169 $ 66,872 $ — $ 78,041

Inventory (Tables)

Inventory (Tables)	3 Months Ended
	Mar. 31, 2022
Inventory Disclosure [Abstract]
Schedule of Inventory, Current	Inventory consisted of the following (in thousands): March 31, 2022 December 31, 2021 Raw materials $ 8,322 $ 7,274 Work-in-process 2,501 1,932 Finished goods 5,891 5,653 $ 16,714 $ 14,859

Accrued Expenses and Other Cu_2

Accrued Expenses and Other Current Liabilities (Tables)	3 Months Ended
	Mar. 31, 2022
Accrued Expenses And Other Current Liabilities [Abstract]
Schedule of Accrued Expenses and Other Current Liabilities	Accrued expenses and other current liabilities consisted of the following (in thousands): March 31, 2022 December 31, 2021 Accrued research, development and clinical trials expenses $ 4,532 $ 4,567 Accrued payroll and related expenses 5,819 5,173 Accrued professional fees 857 1,973 Accrued other 4,530 4,624 $ 15,738 $ 16,337

Long-term Debt (Tables)

Long-term Debt (Tables)	3 Months Ended
	Mar. 31, 2022
Debt Disclosure [Abstract]
Schedule of Long-term Debt Instruments	Long-term debt consisted of the following (in thousands): March 31, 2022 December 31, 2021 Principal amount of long-term debt $ 35,000 $ 35,000 Less: Current portion of long-term debt — — Long-term debt, net of current portion 35,000 35,000 Debt discount, net of accretion (428 ) (511 ) Accrued end-of-term payment 762 708 Long-term debt, net of discount and current portion $ 35,334 $ 35,197

Stock-Based Compensation (Table

Stock-Based Compensation (Tables)	3 Months Ended
	Mar. 31, 2022
Stockholders Equity Note [Abstract]
Schedule of Stock-Based Compensation Expense	The Company recorded stock-based compensation expense in the following expense categories of its consolidated statements of operations (in thousands): Three Months Ended March 31, 2022 2021 Cost of revenue $ 25 $ 13 Research, development and clinical trials expenses 321 197 Selling, general and administrative expenses 1,964 902 $ 2,310 $ 1,112

Segment Reporting and Geograp_2

Segment Reporting and Geographic Data (Tables)	3 Months Ended
	Mar. 31, 2022
Segment Reporting [Abstract]
Long-lived assets by geographical area	See Note 11 for revenue by country. Long-lived assets by geography are summarized as follows (in thousands): March 31, 2022 December 31, 2021 Long-lived assets by country(1): United States $ 11,317 $ 9,085 All other countries 727 756 Total long-lived assets $ 12,044 $ 9,841 ( 1 ) The Company’s only long-lived assets consist of property and equipment, net of depreciation, which are categorized based on their location of domicile.

Revenue (Tables)

Revenue (Tables)	3 Months Ended
	Mar. 31, 2022
Revenue From Contract With Customer [Abstract]
Schedule of Recognized Revenue Net of Payments	The reconciliation of gross revenue to net revenue for these certain payments is shown below (in thousands): Three Months Ended March 31, 2022 2021 Gross revenue from sales to customers $ 15,880 $ 7,637 Less: clinical trial payments reducing revenue — 584 Total net revenue $ 15,880 $ 7,053
Schedule of Net Revenue by OCS Product and Country	The Company disaggregates revenue from contracts with customers by product 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): Three Months Ended March 31, 2022 2021 Net revenue by OCS product: OCS Lung net revenue $ 2,298 $ 2,430 OCS Heart net revenue 5,713 4,181 OCS Liver net revenue 7,869 442 Total net revenue $ 15,880 $ 7,053 Three Months Ended March 31, 2022 2021 Net revenue by country(1): United States $ 13,561 $ 5,757 All other countries 2,319 1,296 Total net revenue $ 15,880 $ 7,053 (1) Net revenue by country is categorized based on the location of the end customer.

Nature of the Business and Ba_2

Nature of the Business and Basis of Presentation - Additional Information (Detail) - USD ($) $ in Thousands	3 Months Ended		12 Months Ended
	Mar. 31, 2022	Mar. 31, 2021	Dec. 31, 2021
Accounting Policies [Abstract]
Net loss	$ 10,562	$ 7,917	$ 44,200
Accumulated deficit	453,008		$ 442,446
Cash equivalents and marketable securities	$ 72,000

Summary of Significant Accoun_4

Summary of Significant Accounting Policies - Additional Information (Detail)	3 Months Ended		12 Months Ended
	Mar. 31, 2022USD ($)Segment	Mar. 31, 2021	Dec. 31, 2021USD ($)
Allowance for credit losses | $	$ 0		$ 0
Number of operating segments | Segment	1
Customer Concentration Risk | Revenue Benchmark | Significant Customer Benchmark [Member] | Minimum [Member]
Concentration risk percentage	10.00%
Customer Concentration Risk | Revenue Benchmark | Customer One [Member]
Concentration risk percentage	16.00%	12.00%
Customer Concentration Risk | Revenue Benchmark | Customer Two [Member]
Concentration risk percentage	15.00%	12.00%
Customer Concentration Risk | Revenue Benchmark | Customer Three [Member]
Concentration risk percentage	12.00%
Customer Concentration Risk | Accounts Receivable | Significant Customer Benchmark [Member] | Minimum [Member]
Concentration risk percentage	10.00%
Customer Concentration Risk | Accounts Receivable | Customer One [Member]
Concentration risk percentage	14.00%		21.00%
Customer Concentration Risk | Accounts Receivable | Customer Two [Member]
Concentration risk percentage	12.00%		15.00%
Customer Concentration Risk | Accounts Receivable | Customer Three [Member]
Concentration risk percentage	12.00%
Customer Concentration Risk | Accounts Receivable | Customer Four [Member]
Concentration risk percentage	10.00%

Summary of Significant Accoun_5

Summary of Significant Accounting Policies - Summary of Potentially Dilutive Securities Excluded from Calculation of Diluted Net Loss Per Share (Detail) - shares	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Antidilutive Securities Excluded from Computation of Earnings Per Share Amount	3,555,148	2,835,198
Warrants to purchase common stock [Member]
Antidilutive Securities Excluded from Computation of Earnings Per Share Amount	64,440	64,440
Options to purchase common stock [Member]
Antidilutive Securities Excluded from Computation of Earnings Per Share Amount	3,484,914	2,764,876
Employee stock purchase plan [Member]
Antidilutive Securities Excluded from Computation of Earnings Per Share Amount	5,794	5,882

Marketable Securities - Compone

Marketable Securities - Components of Marketable Securities by Security Type (Detail) - USD ($) $ in Thousands	Mar. 31, 2022	Dec. 31, 2021
Schedule Of Available For Sale Securities [Line Items]
Marketable Securities, Amortized Cost	$ 54,213	$ 66,908
Marketable Securities, Gross Unrealized Losses	(109)	(36)
Marketable Securities, Fair Value	54,104	66,872
U.S. Treasury Securities (due within one year) [Member]
Schedule Of Available For Sale Securities [Line Items]
Marketable Securities, Amortized Cost	51,212	63,907
Marketable Securities, Gross Unrealized Losses	(102)	(33)
Marketable Securities, Fair Value	51,110	63,874
U.S. Government Agency Bonds (due within one year) [Member]
Schedule Of Available For Sale Securities [Line Items]
Marketable Securities, Amortized Cost	3,001	3,001
Marketable Securities, Gross Unrealized Losses	(7)	(3)
Marketable Securities, Fair Value	$ 2,994	$ 2,998

Fair Value of Financial Asset_3

Fair Value of Financial Assets and Liabilities - Schedule of Fair Value, Assets and Liabilities Measured on Recurring Basis (Detail) - USD ($) $ in Thousands	Mar. 31, 2022	Dec. 31, 2021
Marketable securities:
Marketable securities	$ 54,104	$ 66,872
Cash equivalents and marketable securities	56,951	78,041
U.S. Treasury Securities [Member]
Marketable securities:
Marketable securities	51,110	63,874
U.S. Government Agency Bonds [Member]
Marketable securities:
Marketable securities	2,994	2,998
Money Market Funds [Member]
Cash equivalents:
Cash equivalents	2,847	11,169
Level 1 [Member]
Marketable securities:
Cash equivalents and marketable securities	2,847	11,169
Level 1 [Member] | Money Market Funds [Member]
Cash equivalents:
Cash equivalents	2,847	11,169
Level 2 [Member]
Marketable securities:
Cash equivalents and marketable securities	54,104	66,872
Level 2 [Member] | U.S. Treasury Securities [Member]
Marketable securities:
Marketable securities	51,110	63,874
Level 2 [Member] | U.S. Government Agency Bonds [Member]
Marketable securities:
Marketable securities	$ 2,994	$ 2,998

Inventory - Schedule of Invento

Inventory - Schedule of Inventory, Current (Detail) - USD ($) $ in Thousands	Mar. 31, 2022	Dec. 31, 2021
Inventory Disclosure [Abstract]
Raw materials	$ 8,322	$ 7,274
Work-in-process	2,501	1,932
Finished goods	5,891	5,653
Inventory, net	$ 16,714	$ 14,859

Inventory - Additional Informat

Inventory - Additional Information (Detail) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Inventory Disclosure [Abstract]
Inventory transfer to property plant and equipment	$ 1,030	$ 429

Accrued Expenses and Other Cu_3

Accrued Expenses and Other Current Liabilities - Schedule of Accrued Expenses and Other Current Liabilities (Detail) - USD ($) $ in Thousands	Mar. 31, 2022	Dec. 31, 2021
Accrued Expenses And Other Current Liabilities [Abstract]
Accrued research, development and clinical trials expenses	$ 4,532	$ 4,567
Accrued payroll and related expenses	5,819	5,173
Accrued professional fees	857	1,973
Accrued other	4,530	4,624
Accrued expenses and other liabilities current	$ 15,738	$ 16,337

Long-term Debt - Additional Inf

Long-term Debt - Additional Information (Detail) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2022	Dec. 31, 2021	Jun. 29, 2018
Long-term Debt, Gross	$ 35,000	$ 35,000
Orbi Med [Member]
Long-term Debt, Gross			$ 35,000
Description of variable rate basis	London Interbank Offered Rate (“LIBOR”), subject to a minimum of 1.0% and a maximum of 4.0%
Basis spread on variable rate	8.50%
Interest rate effective percentage	9.50%
Final payment	3.00%
Description of covenants	The financial covenants include maintaining a minimum liquidity amount of $3.0 million; the requirement, on an annual basis, to deliver to OrbiMed annual audited financial statements with an unqualified audit opinion from the Company’s independent registered public accounting firm; and restrictions on the Company’s activities, including limitations on dispositions, mergers or acquisitions; encumbering its intellectual property; incurring indebtedness or liens; paying dividends; making certain investments; and engaging in certain other business transactions.
Minimum liquidity covenant amount	$ 3,000
Average effective interest rate	11.20%
Orbi Med [Member] | In Event Of Default [Member]
Increasing applicable margin	4.00%
Orbi Med [Member] | Credit Agreement [Member]
Debt instrument, maturity month and year	2023-06
Orbi Med [Member] | Minimum [Member]
Paid in kind interest threshold	11.50%
Orbi Med [Member] | Maximum [Member]
Interest rate effective percentage	11.50%
Paid in kind interest threshold	12.50%
Orbi Med [Member] | London Interbank Offered Rate (LIBOR) | Minimum [Member]
LIBOR rate	1.00%
Orbi Med [Member] | London Interbank Offered Rate (LIBOR) | Maximum [Member]
LIBOR rate	4.00%

Long-term Debt - Schedule of Lo

Long-term Debt - Schedule of Long-term Debt Instruments (Detail) - USD ($) $ in Thousands	Mar. 31, 2022	Dec. 31, 2021
Debt Disclosure [Abstract]
Principal amount of long-term debt	$ 35,000	$ 35,000
Long-term debt, net of current portion	35,000	35,000
Debt discount, net of accretion	(428)	(511)
Accrued end-of-term payment	762	708
Long-term debt, net of discount and current portion	$ 35,334	$ 35,197

Stock-Based Compensation - Addi

Stock-Based Compensation - Additional Information (Detail) - USD ($) $ / shares in Units, $ in Millions	Apr. 15, 2019	Mar. 31, 2022	Aug. 31, 2021
Unrecognized compensation cost related to unvested employee and director stock-based awards		$ 24.6
Weighted average period for unrecognized compensation cost		3 years 1 month 6 days
Common Stock | Employees and Directors [Member]
Options granted		880,910
Share-based compensation arrangement by share-based payment award, options, grants in period, weighted average grant date fair value		$ 7.11
2019 Stock Plan [Member]
Share-based compensation arrangement by share-based payment award, number of shares authorized	3,428,571
Share based compensation arrangement by share based payment award number of shares available for grant		890,558
2019 Stock Plan [Member] | From 2014 Plan [Member]
Share-based compensation arrangement by share-based payment award, number of shares authorized	1,595,189
2019 Employee Stock Purchase Plan [Member]
Share-based compensation arrangement by share-based payment award, number of shares authorized		371,142
Share based compensation arrangement by share based payment award number of shares available for grant		308,131
Purchase price of common stock, percent	85.00%
Number of shares issued		12,465
2021 Inducement Plan [Member] | Common Stock
Share-based compensation arrangement by share-based payment award, number of shares authorized			1,000,000
Share based compensation arrangement by share based payment award number of shares available for grant		580,200

Stock-Based Compensation - Sche

Stock-Based Compensation - Schedule of Stock-Based Compensation Expense (Detail) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Allocated Share-based Compensation Expense	$ 2,310	$ 1,112
Cost of revenue [Member]
Allocated Share-based Compensation Expense	25	13
Research, development and clinical trials expenses [Member]
Allocated Share-based Compensation Expense	321	197
Selling, general and administrative expenses [Member]
Allocated Share-based Compensation Expense	$ 1,964	$ 902

Commitments and Contingencies -

Commitments and Contingencies - Additional Information (Detail) - USD ($) $ in Millions	1 Months Ended	3 Months Ended	12 Months Ended
	Jan. 31, 2021	Mar. 31, 2022	Dec. 31, 2021
Defined contribution plan, contribution amount		$ 0	$ 0
Recorded unconditional purchase commitment, minimum quantity required	$ 9.5
Recorded unconditional purchase commitment, maturity year and month	2029-12
Remaining purchase commitment		8
Maximum [Member]
Guaranteed minimum annual royalty payment		$ 0.1

Segment Reporting and Geograp_3

Segment Reporting and Geographic Data - Additional Information (Detail)	3 Months Ended
	Mar. 31, 2022Segment
Segment Reporting [Abstract]
Number of operating segments	1

Segment Reporting and Geograp_4

Segment Reporting and Geographic Data - Geographic Areas Long Lived Assets (Detail) - USD ($) $ in Thousands		Mar. 31, 2022	Dec. 31, 2021
Geographic Areas, Long-Lived Assets [Abstract]
Long-lived assets	[1]	$ 12,044	$ 9,841
United States [Member]
Geographic Areas, Long-Lived Assets [Abstract]
Long-lived assets	[1]	11,317	9,085
All Other Countries [Member]
Geographic Areas, Long-Lived Assets [Abstract]
Long-lived assets	[1]	$ 727	$ 756
[1]	The Company’s only long-lived assets consist of property and equipment, net of depreciation, which are categorized based on their location of domicile

Revenue - Schedule of Recognize

Revenue - Schedule of Recognized Revenue Net of Payments (Detail) - USD ($) $ in Thousands		3 Months Ended
		Mar. 31, 2022	Mar. 31, 2021
Revenue From Contract With Customer [Abstract]
Gross revenue from sales to customers		$ 15,880	$ 7,637
Less: clinical trial payments reducing revenue			584
Total net revenue	[1]	$ 15,880	$ 7,053
[1]	Net revenue by country is categorized based on the location of the end customer.

Revenue - Additional Informatio

Revenue - Additional Information (Detail) - USD ($)	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021	Dec. 31, 2021
Revenue From Contract With Customer [Abstract]
Research development and clinical trials expenses	$ 500,000	$ 500,000
Contract assets	0		$ 0
Performance obligations totaled	$ 2,100,000
Revenue performance obligation description of timing	The Company generally satisfies performance obligations within one year of the contract inception date.

Revenue - Schedule of Net Reven

Revenue - Schedule of Net Revenue by OCS Product and Country (Detail) - USD ($) $ in Thousands		3 Months Ended
		Mar. 31, 2022	Mar. 31, 2021
Disaggregation Of Revenue [Line Items]
Net revenue	[1]	$ 15,880	$ 7,053
United States [Member]
Disaggregation Of Revenue [Line Items]
Net revenue	[1]	13,561	5,757
All Other Countries [Member]
Disaggregation Of Revenue [Line Items]
Net revenue	[1]	2,319	1,296
OCS Lung net revenue [Member]
Disaggregation Of Revenue [Line Items]
Net revenue		2,298	2,430
OCS Heart net revenue [Member]
Disaggregation Of Revenue [Line Items]
Net revenue		5,713	4,181
OCS Liver net revenue [Member]
Disaggregation Of Revenue [Line Items]
Net revenue		$ 7,869	$ 442
[1]	Net revenue by country is categorized based on the location of the end customer.

Related Party Transactions - Ad

Related Party Transactions - Additional Information (Detail) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Director [Member]
Related Party Transaction [Line Items]
Compensation expense	$ 0.1	$ 0.1