named-readtables has largely solved the packaging issue of read macros.
Documentation for merge-readtables-into:
"If a macro character appears in more than one of the readtables, i.e. if a conflict is discovered during the merge, an error of type READER-MACRO-CONFLICT is signaled."
At their core, reader-macros are abbreviations. Obviously there are a finite number of abbreviations one can use, so any time you want to add concise syntax from more than one source, there is a chance of conflict.