AUTHOR=Helanterä Ilkka , Ortiz Fernanda , Havula Essi , Tuominen Samuli , Hakamäki Markus , Hellman Tapio , Mäkelä Satu , Korhonen Riku 
  
TITLE=The frequency and timing of leukopenia and CMV infections in kidney transplant recipients in Finland – a retrospective observational study
  
JOURNAL=Transplant International
  
VOLUME=Volume 39 - 2026
  
YEAR=2026
  
URL=https://www.frontierspartnerships.org/journals/transplant-international/articles/10.3389/ti.2026.16893
  
DOI=10.3389/ti.2026.16893
  
ISSN=1432-2277
  
ABSTRACT=This retrospective observational study investigated the frequency of post-transplant leukopenia and neutropenia (PTLN) and its association with cytomegalovirus (CMV) infections, clinical outcomes, and healthcare resource utilization (HCRU) in kidney transplant recipients (KTRs) in Finland. Clinical and HCRU data were collected from electronic medical records and national registries for the years 2013–2022. Clinical outcomes were assessed during the first 18 months, and cost-related outcomes were evaluated up to 4 years post-transplant. The cohort included 966 KTRs, with the following donor/recipient CMV serostatus distribution: R+ 706 (73.1%), D+/R─ 200 (20.7%), and D─/R─ 60 (6.2%). At 12 months, PTLN occurred in 224 (31.7%) R+, 103 (51.5%) D+/R─, and 6 (10.0%) D─/R─ recipients (p < 0.001). Valganciclovir prophylaxis was started in 28.0% of R+ and 95.0% of D+/R─ patients. CMV DNAemia occurred in 357 (50.6%) R+ and 106 (53.0%) D+/R─ recipients, with median time to CMV DNAemia of 66 days (IQI: 48–110) in R+ and 239 days (IQI: 175–323) in D+/R─ recipients (p < 0.001). PTLN and D+/R─ serostatus were associated with higher HCRU and increased healthcare costs. In conclusion, PTLN was more common in CMV D+/R─ KTRs and both D+/R─ serostatus and PTLN were linked to greater healthcare utilization and cost burden.