*Purpose: Recent events in the media and sporting industry highlight traumatic brain injury (TBI) as a major health concern, having implications in many areas of medicine. Given the limited knowledge concerning disease process and treatment of TBI, there is a need for studies which examine contributing factors. We examined patients who suffered from TBI and also have a history of renal transplantation.

*Methods: The National Inpatient Sample database of Healthcare Cost and Utility Project between 2008 and 2014 was used. Patients with a diagnosis of TBI were identified and divided into those with a history of transplantation (HTx) and non-transplant recipients (No-HTx). These were compared for differences in demographics, complications, and other factors related to their care.

*Results: 209,250 patients met inclusion criteria with 1,240 (0.6%) having a prior history of transplantation. HTx were more likely to be older and to demonstrate a higher in-hospital mortality index score (71.3 vs 64.1, p<.001 and 8 vs 0, p<.001, respectively). For severity, HTx were less likely to have lost consciousness and to require ventriculostomy placement (53.2% vs 41.1%, p<.001 and 1.4% vs 2.5%, p=0.012, respectively). However, HTx were more likely to suffer a seizure and require red blood cell (RBC) transfusion during their hospital stay (6.94% vs 5.58%, p=0.039 and 12.10% vs 8.12%, p<.001, respectively). Finally, HTx patients were more likely to have a longer in-hospital stay (5 vs 4 days, p=.001), require transfer to a skilled nursing facility (40.4% vs 35.8%, p=.001), and need home-health care (13.5% vs 9.6%, p<.001).

*Conclusions: While HTx patients unsurprisingly have higher in-hospital mortality index score, differences in specific central nervous system complications, namely incidence of seizure, and necessary intra-cranial interventions, such as ventriculostomy placement, suggests the possibility that the pathological process is different between transplant and non-transplant recipients. Given that a history of transplantation seems to have implications for care of patients with TBI, additional studies are needed to investigate a potential relationship between the pathological processes that necessitate renal transplantation and the pathophysiology of TBI.

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