A California man living with hepatitis C virus (HCV) has made history as one of the first people in the United States to receive a combination heart and liver transplant. The procedure, performed at the University of California at San Diego’s Cardiovascular Center in La Jolla, is one of just 16 such surgeries performed nationwide this year, The San Diego Union-Tribune reports. 

Frank “Sonny” Taitano, 58, underwent the 10-hour combination surgery in November after suffering from heart failure symptoms for 11 years. He has been convalescing at the hospital’s cardiology center since then as his health providers make sure his immune system does not reject the new organs and to treat a previously undetected hepatitis C infection that attacked his former liver. This week, Taitano and his physicians agreed he had recovered enough to talk with journalists about the surgery from his bedside.

According to doctors, Taitano suffered from a hereditary heart condition called nonischemic cardiomyopathy, which weakened his heart muscle and surrounded it with fluid. The fluid buildup and lack of proper blood circulation irreparably damaged his liver. When a matching heart and liver became available simultaneously, UC San Diego doctors decided it was time to move ahead with the rare surgery. 

According to the Organ Procurement and Transplantation Network, concurrent heart and liver transplants are exceedingly rare in the United States, making up less than 1 percent of all transplant operations performed in this country. Doctors say logistics are notoriously difficult with such a surgery, which is essentially two moderately difficult operations performed back-to-back.

Studies show that the survival of patients who undergo a combination heart-liver surgery is nearly as good as those who have only one or the other organ replaced. However, experts say finding two acceptable organs for transplant in the United States is hard—transplant programs that commented on the surgery said they’d need far more donated organs to make outcomes like Taitano’s more commonplace. 

According to federal data, more than 134,000 Americans have died since 1992 while waiting on organ transplant lists, and the number of donors is decreasing for many organs in the United States.