Conclusion FKplasm and IPV during induction are higher than in EM and LM. However, patients with CV >30% remain in the maintenance periods between 29.9% and 31.8%, and with values<5 ng/ml between 9.3% and 13.1% which would justify a greater need for pharmacokinetic monitoring and therapeutic control, in order to preserve a longer graft survival and to minimise the events of pharmacological adverse reactions.

to intolerance and three patients (with normal TPMT levels) due to recurrent hepatotoxicity. 30/44 patients tolerated combined therapy. 27/30 patients achieved an optimised TGN: MeMP ratio (<11). Specific ratios included 0 (n=13), 1 (n=9), 2 (n=4), 3 (n=1). 3/30 patients required Allopurinol 100 mg to obtain a ratio <11. Conclusion The majority of patients (90%) obtained an effective TGN:MeMP ratio with reduced Allopurinol dosing at 50 mg. Those that did not achieve this ratio (10%) responded to dose escalation to 100 mg. TPMT status did not appear to influence the effect of low-dose Allopurinol. Hepatotoxicity may still occur with combined Allopurinol and thiopurines therapy. Low-dose Allopurinol may be considered a viable therapeutic strategy providing that appropriate clinical and biochemical surveillance is maintained.

to intolerance and three patients (with normal TPMT levels) due to recurrent hepatotoxicity. 30/44 patients tolerated combined therapy. 27/30 patients achieved an optimised TGN: MeMP ratio (<11). Specific ratios included 0 (n=13), 1 (n=9), 2 (n=4), 3 (n=1). 3/30 patients required Allopurinol 100 mg to obtain a ratio <11. Conclusion The majority of patients (90%) obtained an effective TGN:MeMP ratio with reduced Allopurinol dosing at 50 mg. Those that did not achieve this ratio (10%) responded to dose escalation to 100 mg. TPMT status did not appear to influence the effect of low-dose Allopurinol. Hepatotoxicity may still occur with combined Allopurinol and thiopurines therapy. Low-dose Allopurinol may be considered a viable therapeutic strategy providing that appropriate clinical and biochemical surveillance is maintained. REFERENCES AND/OR ACKNOWLEDGEMENTSThanks to gastroenterologists and the chief pharmacist.No conflict of interest.

Conclusion FKplasm and IPV during induction are higher than in EM and LM. However, patients with CV >30% remain in the maintenance periods between 29.9% and 31.8%, and with values<5 ng/ml between 9.3% and 13.1% which would justify a greater need for pharmacokinetic monitoring and therapeutic control, in order to preserve a longer graft survival and to minimise the events of pharmacological adverse reactions.