PURPOSE: Our aim was to determine the association between the development of post-transplant neutropenia and subsequent antibody-mediated rejection (AMR) in a population of adult lung transplant recipients. METHODS: We performed a single center retrospective cohort study of adult lung transplant recipients between 2008 and 2013. Neutropenia was defined as an absolute neutrophil count (ANC) <= 1500 and categorized as mild (ANC<1500), moderate (<1000) or severe (ANC<500). AMR was defined according to ISHLT consensus guidelines. Cox Regression analysis was performed to evaluate AMR-free survival in patients with and without post-transplant neutropenia. RESULTS: The cohort included 228 lung transplant recipients, 101 (42.1%) of whom developed neutropenia. Of those patients who developed neutropenia, 42 had mild neutropenia, 34 had moderate neutropenia and 25 had severe neutropenia. Patients with Neutropenia had a significant increased risk of subsequent AMR (OR 3.16, 95% CI 1.37-7.28, p=0.005). Additionally, patients who developed neutropenia had decreased AMR-free survival (HR for death 2.90, 95% CI 1.32-6.37, p=0.008). This relationship appeared to correlate with degree of neutropenia. Patients with severe moderate and severe neutropenia had lower AMR-free survival than patients with mild or no neutropenia. CONCLUSION: The development of neutropenia is associated with an increased risk of subsequent AMR in lung transplant recipients. Further investigation into the underlying mechanism of this association is warranted.