Three combined heart and delayed kidney transplantations were carried out between 1992 and 1998. The patients received induction therapy with antithymocyte immunoglobulin and were maintained on triple immunosuppressive therapy (cyclosporin, azathioprine, and prednisone). All are currently alive with satisfactory transplanted organ function. The medical histories, clinical course, and outcomes are described. Heart and delayed kidney transplantation with allografts from the same donor appears to be effective treatment for selected patients with end-stage cardiac and renal disease.