The major cause of morbidity and mortality after cardiac transplantation is cardiac allograft vasculopathy (CAV). The purpose of this study was to examine the expression of markers of endothelial injury that may be affected by blood/insulin or crystalloid cardioplegia. After RNA-blot hybridization, the level of expression of tumor necrosis factor-alpha, transforming growth factor-beta (TGF-beta), intracellular adhesion molecule-1, platelet-endothelial cell adhesion molecule-1, endothelin-1, and E-selectin was increased in crystalloid cardioplegia as compared with normal and blood/insulin cardioplegia; TGF-beta was expressed at significantly lower levels in blood/insulin vs crystalloid cardioplegia (p < 0.05). Because increased expression of TGF-beta has been correlated with accelerated CAV, the use of blood/insulin cardioplegia may help to decrease the extent of endothelial damage and attenuate the progression of CAV.