BACKGROUND: The effect of dialysis modality on posttransplant oliguria, DGF, rejection episodes before discharge and creatinine not declining by >25% as early indicators for graft successfulness has not been addressed using propensity-matching approach. OBJECTIVES: To compare post-TX Oliguria, DGF, rejections before discharge, and creatinine not declining by > 25% between pretransplant HD and PD for adults with ESRD in the US. METHODS: A propensity-matched retrospective study of renal recipients between January 2007 and December 2011, following ≥60 days of maintenance dialysis. All the data were obtained from the USRDS for the period 2006 to 2012. Adults who received either kidney or kidney/pancreas, with ≥6 months of pre-TX history were included. Patients with other organ transplants, two or more prior renal TXs, and missing data were excluded. Incidence rates and rate differences (R-Diff.) along with multiple logistic regression analyses were used. Our p-value was adjusted using Bonferroni correction for multiple comparisons. RESULTS: A total of 19,612 renal recipients (9,806 pairs) were included. No difference in follow-up (HD=36.51 vs PD=36.08 months, p-value =0.0807). Nearly, 50% of recipients had 2-18 months of pretransplant dialysis. Incidence rates of those outcomes were significantly higher among HD patients (R-Diff. p-value <.0001). Compared to PD, Hemodialysis presented significantly higher risks of oliguria (OR=1.44), delayed-graft functioning (OR=1.94) rejection episodes before discharge (OR=1.38), and creatinine not declining >25% (OR=1.23). Recipients who were male, publicly insured, received a cadaveric organ, administered steroids as an initial immunosuppressant and those didn’t utilize Calcineurin inhibitors had significant odds of developing those outcomes. CONCLUSIONS: Hemodialysis ≥60 days prior to renal TX was associated with significantly higher odds of developing post-TX oliguria, DGF, rejection episodes before discharge, and creatinine not declined >25% compared to PD.