Combined heart and kidney transplantation is one of the treatment options in patients with end- stage heart and renal failure. In this brief communication we present the first combined heart and kidney transplantation in Turkey, from the same donor. Our patient was a 33 years old male with dilated cardiomyopathy and dialysis dependent renal failure. Biatrial orthotopic cardiac transplantation was performed with a 103 minutes of ischemic period. Just after the termination of cardiac transplantation renal transplantation was performed. The ischemic period for kidney was 6 hours. In the postoperative period, immunosuppresive treatment was initiated like our other patients with isolated cardiac transplantation. Patient was discharged from the hospital in the 15th postoperative day in good condition with optimal cardiac performance and renal functions. In the follow up period there was no problem in both organs after 2 months. Combined heart and kidney transplantation was first descibed in 1978. There are a few patients reported in the literature. The similarity of survival between isolated heart transplantation and combined heart and kidney transplantation, and low incidence of rejection when compared with isolated heart and isolated renal transplantation is encouraging for this challenging type of operation.