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Rejection of solid organ allografts by the recipient immune system is mediated, to a major extent, by T cell effector mechanisms. Granzymes and perforin are protein regulators of cytotoxic T lymphocyte-mediated target cell death. In this review, I discuss clinical data implicating granzymes and perforin in acute and chronic solid organ transplant rejection, as well as data from cell and animal experiments that support a main role for these effector molecules in allograft rejection.

Granzymes and perforin in solid organ transplant rejection