Strong Organic and Logistics Growth
Q4 logistics (organic) revenue grew 35.3% year-over-year to $49.2M (prior-year $36.4M). Company cited organic growth of ~35% in Q4 overall, driving a strong quarterly performance and sustained volume into 2026.
Full-Year Results Beat Guidance
Full-year 2025 revenue of $197.1M and adjusted EBITDA of $14.1M both beat the high end of prior guidance ranges, supported by the strong Q4 performance.
Material Improvement in Profitability Metrics
Q4 gross profit increased 90% to $14.4M versus $7.6M prior-year; blended gross margin improved ~80 basis points to 21.6% from 20.8%. Logistics gross profit rose 39.5% to $10.6M with a ~70-basis-point improvement in logistics gross margin to 21.5%.
Adjusted EBITDA Recovery and Margin Expansion
Adjusted EBITDA increased to $7.0M in Q4 2025 (from $1.1M year-ago and $4.2M last quarter). Q4 adjusted EBITDA margin was 10.4%, and company raised 2026 adjusted EBITDA guidance to $29–$33M (from $28–$32M).
Upgraded 2026 Revenue Guidance and Strong Cash Position
2026 revenue guidance raised to $260–$275M (from $255–$270M). Company ended Q4 with no debt and approximately $61.0M of cash and short-term investments, and reiterated free cash flow before aircraft/engine purchases guidance of $15–$22M.
Successful Keystone Integration and Strategic M&A Platform
First full quarter post-Keystone close produced $17.6M of clinical revenue in Q4 (transplant clinical $7.8M; other clinical $9.8M). Management expects continued M&A to accelerate adjusted EBITDA growth at least 30% annually and closed a $30M asset-based credit facility (undrawn, expandable to $50M) to support acquisitions.
Regulatory Tailwinds and Service Differentiation
Proposed CMS/OPTN actions (incentives for DCD donors, continuous distribution momentum for lungs) align with the company's capabilities (NRP and DCD expertise). Approximately 20% of revenue is from OPOs; Tier 1 OPO customers represent 2.4x the revenue of Tier 3 OPOs. Recent decertification/absorption of an underperforming OPO directly led to new business.
Fleet Strategy Produces Business Benefits
Company maintains an asset-light model complemented by ~30 dedicated/owned aircraft. Owning a small portion of capacity unlocked new business, aided negotiations with third-party carriers, and management plans to add ~two owned aircraft in 2026 to support new geographies; one aircraft already acquired in Q1 and in conformity process.