Blood group antigen expression was assessed in cardiac tissue taken during heart transplantation. The samples were from ten donors and nine recipients, of whom seven were blood group A, three were group B, two were group AB, and seven were group O. Cryostat sections were studied by immunofluorescence microscopy. Blood group antigens were confined to the mesothelial cells on the surface of the epicardium and the cardiovascular endothelium where they were consistently demonstrated according to erythrocyte blood group using a rabbit anti-A serum, monoclonal antibodies against A and B antigens, and the H antigen-specific lectin Ulex europaeus. The cardiac muscle itself was negative for blood group antigen. The results indicate that there is some variation in antigen expression between individuals, which may explain why transplants have occasionally been successful in breaching the blood group ABO barrier.