After heart transplantation a high incidence of infections and malignancies is found. Not only immunosuppression, but also intrinsic cytokine systems with some unbalance, e. g. TNF-alpha and IL-2, can result in impaired immune competence and may have a role in these complications. The aim of this study was to assess the activity of the TNF-alpha and IL-2 systems after heart transplantation. In peripheral blood we measured expression of activation markers of TNF-alpha (TNF-R2) and IL-2 (IL-2R alpha, IL-2R beta-chain) on monocytes and lymphocytes using quantitative flow-cytometric analysis. TNF-R2 expression was significantly enhanced on monocytes and lymphocytes in patients after heart transplantation, while the expression of IL-2R alpha and IL-2R beta was not elevated. Increased TNF-R2 expression in peripheral blood after heart transplantation reflects an activated TNF-alpha system, leading to high levels of active sTNF-R, which impairs TNF-alpha bioavailibility and consequently leads to immune incompetence.