ATC Abstracts

American Transplant Congress abstracts

  • Home
  • Meetings Archive
    • 2022 American Transplant Congress
    • 2021 American Transplant Congress
    • 2020 American Transplant Congress
    • 2019 American Transplant Congress
    • 2018 American Transplant Congress
    • 2017 American Transplant Congress
    • 2016 American Transplant Congress
    • 2015 American Transplant Congress
    • 2013 American Transplant Congress
  • Keyword Index
  • Resources
    • 2021 Resources
    • 2016 Resources
      • 2016 Welcome Letter
      • ATC 2016 Program Planning Committees
      • ASTS Council 2015-2016
      • AST Board of Directors 2015-2016
    • 2015 Resources
      • 2015 Welcome Letter
      • ATC 2015 Program Planning Committees
      • ASTS Council 2014-2015
      • AST Board of Directors 2014-2015
      • 2015 Conference Schedule
  • Search

Pentamidine Prophylaxis in Transplant Recipients

B. Summers, A. Morrison, N. Sulejmani, R. Kenney

Department of Pharmacy, Henry Ford Hospital, Detroit, MI

Meeting: 2020 American Transplant Congress

Abstract number: D-158

Keywords: Adverse effects, Outcome, Prophylaxis

Session Information

Session Name: Poster Session D: All Infections (Excluding Kidney & Viral Hepatitis)

Session Type: Poster Session

Date: Saturday, May 30, 2020

Session Time: 3:15pm-4:00pm

 Presentation Time: 3:30pm-4:00pm

Location: Virtual

*Purpose: Trimethoprim-sulfamethoxazole (TMP-SMX) is preferred therapy for pneumocystis pneumonia (PJP) prophylaxis in solid organ transplant (SOT) recipients, however, use can be limited by allergy and intolerance. Inhaled Pentamidine (IP) is used as second line prophylaxis in those who are unable to receive TMP-SMX. The purpose of this study was to describe the characteristics and outcomes of IP for PJP prophylaxis in SOT recipients.

*Methods: IRB-approved, retrospective descriptive study of SOT recipients across a health system prescribed IP for PJP prophylaxis between January 2017 to November 2019. Patients were included if they were ≥18 years old treated with IP for &gt 1 dose after SOT. Exclusion criteria: pregnancy, developmental delay, prisoners, and patients with graft versus host disease. Primary outcome was the proportion of patients with breakthrough infections. Secondary outcomes included indication and adverse effects.

*Results: 80 subjects were included (7 multivisceral; 18 lung; 24 liver; 31 kidney). Median [IQR] age was 62.5 [54-68.5] years. Total of 504 pentamidine doses were administered with median doses of 6 [4-6]. Indications included 50 (62.5%) intolerance 29 (36.3%) allergy, and 1 (1.2%) multidrug resistant organism colonization. Breakdown of specific intolerances and allergies are listed in Table 1 (some patients had multiple indications). No breakthrough infections were seen. 7 (14%) patients with intolerance were rechallenged with TMP-SMX. 4 (13.7%) with an allergy were rechallenged with TMP-SMX and 2 (6.9%) received an allergy consultation. Overall, 46 (57.5%) patients experienced adverse effects. Breakdown of total adverse effects (n=75): cough/chest tightness/wheezing 58, bronchospasm 13, hypo- or hyperglycemia 2, unanticipated seeking of care for respiratory issue 2.

*Conclusions: IP appeared to be effective; however, tolerability was suboptimal with 57.5% experiencing at least 1 adverse effect. 6.9% of patients with an allergy received an allergy consultation. 14% thought to be intolerant were rechallenged. The results of this study suggest more efforts are needed to properly assess TMP-SMX allergies prior to SOT and to re-evaluate institutional algorithms.

Indications For Pentamidine
Intolerance 50 (62.5%) patients (n=63)
Hyperkalemia 21 (33.3%)
Acute kidney injury 18 (28.6%)
Cytopenia 15 (23.8%)
Allergies 29 (36.3%) patients (n=33)
Hives 13 (39.4%)
Rash  7 (21.2%)
Gastrointestinal related 3 (9.1%)
  • Tweet
  • Email
  • Print

To cite this abstract in AMA style:

Summers B, Morrison A, Sulejmani N, Kenney R. Pentamidine Prophylaxis in Transplant Recipients [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/pentamidine-prophylaxis-in-transplant-recipients/. Accessed May 11, 2025.

« Back to 2020 American Transplant Congress

Visit Our Partner Sites

American Transplant Congress (ATC)

Visit the official site for the American Transplant Congress »

American Journal of Transplantation

The official publication for the American Society of Transplantation (AST) and the American Society of Transplant Surgeons (ASTS) »

American Society of Transplantation (AST)

An organization of more than 3000 professionals dedicated to advancing the field of transplantation. »

American Society of Transplant Surgeons (ASTS)

The society represents approximately 1,800 professionals dedicated to excellence in transplantation surgery. »

Copyright © 2013-2025 by American Society of Transplantation and the American Society of Transplant Surgeons. All rights reserved.

Privacy Policy | Terms of Use | Cookie Preferences