No difference in liver transplant outcomes with penicillin allergy

HOUSTON — Researchers found no differences in outcomes between liver transplant recipients with a penicillin allergy label and matched controls, according to findings presented at the American College of Asthma, Allergy & Immunology Science Meeting.

“In our cohort, having a penicillin allergy label did not impact outcomes in liver transplant recipients,” Gabriel Motoa Cardona, MD, a researcher in the division of pulmonology, allergy and sleep medicine at the Mayo Clinic Florida, said during the presentation.

Cardona presented findings from a study looking at reduction of antibiotic resistance, length of hospital stay, in-hospital complications and infection in liver transplant recipients. The patient population for this study included liver transplant recipients in Mayo Clinic Florida from 2005 to 2016, identified by the Solid Organ Transplant Database and evaluated for a beta-lactam allergy through an Advance Cohort Explorer.

Researchers conducted a 2:1 propensity match for age, liver disease diagnosis, donor risk index, the need for intraoperative transfusion or continuous renal replacement therapy, MELD score and BMI. The study comprised 87 patients with a penicillin allergy label and 174 matched controls.

“Our primary outcomes were mortality at 1 month and 1 year, the readmission date 30 days after the transplant and the length of stay. And our secondary outcomes were the surgical site infections, specifically, the organ-space 30 days after surgery and higher colonization or infection by multidrug-resistant organisms,” Cardona said.

Results showed monobactams as the most used broad-spectrum antibiotics compared with matched controls. For the secondary outcomes of the study, Cardona reported that patients with a penicillin allergy label “had a slightly higher rate of infection and multidrug-resistance organisms” (2.3%) compared with matched controls (1.7%). The study data did not show significant differences in liver transplant patients with a penicillin allergy label when assessed with matched controls.

“Further prospective studies are necessary to confirm these findings,” Cardona said. – by Erin T. Welsh

Reference:

Cardona G, et al. A007. Presented at: American College of Asthma, Allergy & Immunology Scientific Meeting; Nov. 7-11, 2019; Houston.

Disclosure: Cardona reports no financial disclosures.