To summarize the nursing experience of a patient with familial hypertrophic cardiomyopathy complicated with liver failure undergoing combined heart-liver transplantation. To address complex challenges such as dynamic changes in perioperative coagulation function，inter-organ interactions，immunosuppression management，and delayed functional recovery of combined transplanted organs，the following measures were implemented：coagulation function monitoring and nursing care for secondary neurological complications，management of transition from extracorporeal circulation to extracorporeal membrane oxygenation，precise titration and monitoring of minimal effective tidal volume，management of delayed functional recovery in transplanted organs，balance and meticulous monitoring of immunosuppression，and precision nutritional support guided by intra-abdominal pressure. After 34 days of intensive care，the patient was successfully transferred out of the ICU and discharged after recovery.