The effectiveness of cochlear implantation has led to a relaxation of the candidate criteria. Patients who had been rejected in the past may now be accepted and their outcomes are encouraging. However, the acceptance of immunosuppressed patients as cochlear implant candidates is rather challenging as the risk of infection may put not only the device at risk (need for explantation) but also their lives due to a possible infection that may be difficult to control. The authors describe the first reported case of successful cochlear implantation in a patient who had previously undergone successful combined liver and kidney transplant. The authors describe the precautions that they had taken in order to minimise the risk and claim that they did not have any significant complications from surgery with a very good audiological outcome at three months. However larger studies are needed in order to assess the real risk of cochlear implantation in immunosuppressed patients.