{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T16:40:12Z","timestamp":1790872812419,"version":"4.1.0"},"reference-count":89,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,1,19]],"date-time":"2023-01-19T00:00:00Z","timestamp":1674086400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transplant Infectious Dis"],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Leukopenia and neutropenia (L\/N) may affect treatment decisions, potentially resulting in poor clinical and economic outcomes among kidney transplant recipients (KTRs). The burden of L\/N is poorly quantified systematically. This systematic literature review aimed to summarize the incidence of, risk factors for, and clinical and economic outcomes associated with L\/N post\u2010KT.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We systematically searched MEDLINE, Embase, and the Cochrane Library (from database inception\u2010June 14, 2021) and conferences (past 3 years) to identify observational studies examining epidemiology, risk factors, or outcomes associated with L\/N among adult KTRs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 2081 records, 82 studies met inclusion criteria. Seventy\u2010three studies reported the epidemiology of L\/N post\u2010KT. Pooled incidence of neutropenia, defined as absolute neutrophil counts (ANC) &lt;1000\/\u03bcl, ranged from 13% to 48% within 1\u2010year post\u2010transplant; ANC &lt;500\/\u03bcl ranged from 15% to 20%. Leukopenia, defined as white blood cell counts &lt;3500\/\u03bcl, was 19% to 83%. Eleven studies reported independent risk factors associated with L\/N post\u2010KT. D+\/R\u2212 cytomegalovirus status, mycophenolic acid (MPA), and tacrolimus use were the most consistent risk factors across studies. Fourteen studies reported L\/N\u2010associated clinical outcomes. We noted a trend toward a positive association between neutropenia and acute rejection\/opportunistic infections. Mixed findings were noted on the association between L\/N and graft failure or mortality. Dosage modifications of valganciclovir, MPA, cotrimoxazole, and anti\u2010thymoglobulin and the need for granulocyte colony\u2010stimulating factor (G\u2010CSF) use were common with L\/N.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Findings suggest post\u2010transplant L\/N were common and associated with frequent modifications of immunosuppressive agents, requiring G\u2010CSF use, and rejection or opportunistic infections. Findings highlight the need for interventions to reduce risk of L\/N post\u2010KT.<jats:boxed-text content-type=\"graphic\" position=\"anchor\"><jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" mimetype=\"image\/png\" position=\"anchor\" specific-use=\"enlarged-web-image\" xlink:href=\"graphic\/tid14000-gra-0001-m.png\"><jats:alt-text>image<\/jats:alt-text><\/jats:graphic><\/jats:boxed-text><\/jats:p><\/jats:sec>","DOI":"10.1111\/tid.14000","type":"journal-article","created":{"date-parts":[[2022,12,12]],"date-time":"2022-12-12T18:33:46Z","timestamp":1670870026000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":33,"title":["Burden of neutropenia and leukopenia among adult kidney transplant recipients: A systematic literature review of observational studies"],"prefix":"10.1111","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8265-8612","authenticated-orcid":false,"given":"Amit D.","family":"Raval","sequence":"first","affiliation":[{"name":"Merck &amp; Co., Inc. 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