Serum cholesterol plays a role only in the etiology of ischemic cardiomyopathy and increases in patients after heart transplantation. Aim of the present investigation was to verify whether lipid profile change is related to pre-intervention type of cardiomyopathy and serum cholesterol level. Lipid profile was monthly monitored for at least 6 months in 21 consecutive patients after heart transplantation (19 males and 2 females, mean age 47 +/- 10 years). Serum cholesterol and triglycerides increased in all patients 2 months after surgery and thereafter it persisted significantly elevated. The increase was statistically significant only in patients with dilated cardiomyopathy and with normal cholesterolemia before surgery. In conclusion, lipid profile after heart transplantation should be especially monitored in patients with dilated cardiomyopathy and in those with normal serum cholesterol before heart transplantation.