Staged Kidney Transplantation During Combined Heart/Kidney Transplantation

This study is examining a staged surgical approach to combined heart and kidney transplantation — where the kidney transplant is performed in a separate procedure shortly after the heart transplant, rather than both organs being transplanted simultaneously. The goal is to understand whether this staged strategy leads to better kidney outcomes for patients who need both organs. **You may be eligible if...** - You are 18 or older - You are undergoing a combined heart and kidney transplant at Cedars-Sinai Medical Center in a staged (separate) surgical approach **You may NOT be eligible if...** - Your medical condition required that both the heart and kidney be transplanted during a single simultaneous operation - Your medical record is flagged as "break-the-glass" or "research opt-out" in the hospital's electronic health record system Talk to your doctor to see if this trial is right for you.