Simultaneous heart and lung transplants

How rare and difficult are simultaneous heart/lung transplant operations?

These were mentioned on two shows this week, The West Wing and ER.

On The West Wing, they made it sound like the procedure was extremely rare - that it could only be done in the US or Japan, that Japan had no survivors yet, and that there were only three surgeons in the US who could do it.

However, on ER, it was an emergency procedure done at a county hospital.

I suspect that the truth lies somewhere in between these to portrayals. An insights?

From ["]an article on WebMD.com:](
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Also, a Google search on “heart and lung transplant”, surgeons, qualified revealed quite a few surgeons, both in the U.S. and abroad, who have experience with the procedure – certainly far more than The West Wing would have you think.

As for the accuracy of ER’s plot in conveniently having a transplant surgeon on board, keep in mind that County General is supposed to be a teaching hospital in a major city (Chicago) containing several university medical centers (Northwestern, U of Chicago, DePaul). I’d consider it well likely that a transplant specialist would be available in short order, if not already on County General’s staff.