I haven't seen or heard of any in WV, but they might be out there. My guess is that they use ALS ambulances, chase units, or supervisor/chief vehicles to transport them in cases where ground transportation is needed. They also may use a CCT unit if one is avaliable. I would guess in most cases that they just fly them from pad to pad or from airport to pad via one of the HealthNet, Air Evac, or another providers medivac bird. In most cases the birds are stationed at local airports and if one comes in via fixed wing aircraft they could just put it in a waiting bird to be flown straight to the hospital or vise versa. There are a lot of rural hospitals in WV, so I would imagine if an organ was avaliable they would just fly it out in a bird to the nearest level 1 or 2 center to a patient.