BACKGROUND: Renal Transplant recipients are at risk for developing neutropenia from a multitude of causes. The cause is often multifactorial, and reversal of the most common causes/insults is sometimes insufficient.

CASE REPORT: We present the case of a renal transplant recipient who developed a prolonged course of post-transplant (PTx) neutropenia that resolved after switching from tacrolimus (tac) to cyclosporine (CsA).

CONCLUSIONS: Transplant recipients with persistent neutropenia, sometimes despite discontinuation of potential myelosuppressive agents like mycophenolic acid (MPA), valganciclovir, and sulfamethoxazole-trimethoprim (SMZ-TMP), and with introduction of granulocyte colony-stimulating factor (G-SF), and ruling out alternative diagnoses, may benefit from changing from tac to CsA.

Keywords: Cyclosporine, Kidney Transplantation, Neutropenia, Tacrolimus, calcineurin inhibitors, transplant recipients