title: Influence of early neurological complications on clinical outcome following lung transplant.
abstract: BACKGROUND
  Neurological complications after lung transplantation are common. The full spectrum of neurological complications and their impact on clinical outcomes has not been extensively studied.
  
  
  METHODS
  We investigated the neurological incidence of complications, categorized according to whether they affected the central, peripheral or autonomic nervous systems, in a series of 109 patients undergoing lung transplantation at our center between January 1 2013 and December 31 2014.
  
  
  RESULTS
  Fifty-one patients (46.8%) presented at least one neurological complication. Critical illness polyneuropathy-myopathy (31 cases) and phrenic nerve injury (26 cases) were the two most prevalent complications. These two neuromuscular complications lengthened hospital stays by a median period of 35.5 and 32.5 days respectively. However, neurological complications did not affect patients' survival.
  
  
  CONCLUSIONS
  The real incidence of neurological complications among lung transplant recipients is probably underestimated. They usually appear in the first two months after surgery. Despite not affecting mortality, they do affect the mean length of hospital stay, and especially the time spent in the Intensive Care Unit. We found no risk factor for neurological complications except for long operating times, ischemic time and need for transfusion. It is necessary to develop programs for the prevention and early recognition of these complications, and the prevention of their precipitant and risk factors.
authors.affiliation: Neurology Department, Vall d'Hebron University Hospital, Vall d'Hebron Research Institute, Autonomous University of Barcelona, Barcelona, Spain.
authors.forename: Josep
authors.identifier: http://orcid.org/0000-0003-3127-7486
authors.initials: J
authors.lastname: Gamez
authors.affiliation: Neurology Department, Vall d'Hebron University Hospital, Vall d'Hebron Research Institute, Autonomous University of Barcelona, Barcelona, Spain.
authors.forename: Maria
authors.initials: M
authors.lastname: Salvado
authors.affiliation: Department of Neurophysiology, Vall d'Hebron University Hospital, Autonomous University of Barcelona, Barcelona, Spain.
authors.forename: Alejandro
authors.initials: A
authors.lastname: Martinez-de La Ossa
authors.affiliation: Department of Thoracic Surgery, Lung Transplant Unit, Vall d'Hebron University Hospital, Barcelona, Spain.
authors.forename: Maria
authors.initials: M
authors.lastname: Deu
authors.affiliation: Department of Thoracic Surgery, Lung Transplant Unit, Vall d'Hebron University Hospital, Barcelona, Spain.
authors.forename: Laura
authors.initials: L
authors.lastname: Romero
authors.affiliation: Department of Pulmonology, Lung Transplant Unit, Vall d'Hebron University Hospital, Barcelona, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Roman
authors.affiliation: Critical Care Department, Lung Transplant Unit, Vall d'Hebron University Hospital, Barcelona, Spain.
authors.forename: Judith
authors.initials: J
authors.lastname: Sacanell
authors.affiliation: Critical Care Department, Lung Transplant Unit, Vall d'Hebron University Hospital, Barcelona, Spain.
authors.forename: Cesar
authors.initials: C
authors.lastname: Laborda
authors.affiliation: Department of Anesthesiology, Vall d'Hebron University Hospital, Barcelona, Spain.
authors.forename: Isabel
authors.initials: I
authors.lastname: Rochera
authors.affiliation: Department of Anesthesiology, Vall d'Hebron University Hospital, Barcelona, Spain.
authors.forename: Miriam
authors.initials: M
authors.lastname: Nadal
authors.affiliation: Department of Statistics, University of Barcelona, Barcelona, Spain.
authors.forename: Francesc
authors.initials: F
authors.lastname: Carmona
authors.affiliation: Neurology Department, Vall d'Hebron University Hospital, Vall d'Hebron Research Institute, Autonomous University of Barcelona, Barcelona, Spain.
authors.forename: Estevo
authors.initials: E
authors.lastname: Santamarina
authors.affiliation: Department of Neurophysiology, Vall d'Hebron University Hospital, Autonomous University of Barcelona, Barcelona, Spain.
authors.forename: Nuria
authors.initials: N
authors.lastname: Raguer
authors.affiliation: Department of Thoracic Surgery, Lung Transplant Unit, Vall d'Hebron University Hospital, Barcelona, Spain.
authors.forename: Merce
authors.initials: M
authors.lastname: Canela
authors.affiliation: Department of Thoracic Surgery, Lung Transplant Unit, Vall d'Hebron University Hospital, Barcelona, Spain.
authors.forename: Joan
authors.initials: J
authors.lastname: Solé
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016040:Lung Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011115:Polyneuropathies / Q000209:etiology*; D012189:Retrospective Studies; D016019:Survival Analysis; D055815:Young Adult