4CPS-148 Analysis of intra-patient variability of plasmatic levels of tacrolimus in early maintenance of renal post-transplant

Abstract

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.