Abstract
Tuberculosis infection (TBI) remains one of the most prevalent infectious diseases worldwide and has recently re-emerged in several regions due to disruptions in public-health infrastructure, population mobility, and delayed diagnosis following the COVID-19 pandemic. These global trends underscore the continuing relevance of TBI, particularly among immuno-compromised populations. For individuals with end-stage liver disease (ESLD) undergoing liver transplantation (LT), TBI presents a unique clinical challenge: the immunosuppression required to maintain graft function increases susceptibility to infection and reactivation. Despite this recognized risk, limited U.S. data have examined TBI within LT populations, including its prevalence, associated disparities, and relationship to post-transplant outcomes.This dissertation clarifies the prevalence and distribution of TBI among adult LT candidates over a ten-year period at a major U.S. transplant center and demonstrates that properly managed TBI does not negatively affect graft or patient survival. By integrating a structural equity perspective with epidemiologic data and risk-adjusted outcomes, this work informs transplant practice and policy, emphasizing systematic screening, timely risk-based evaluation, and equitable infection management for individuals with end-stage liver disease preparing for transplantation.