A Physical Activity Program in End-state Liver Disease

Inclusion Criteria: * Age 40 to 70. * Cirrhosis, any cause, defined as: * Biopsy-proven. * Two or more of the following: albumin \<3.5 g/dL, International Normalized Ration (INR) \>1.3, radiologic or endoscopic evidence of portal hypertension. * Creatinine \<2.0 mg/dL. * Physiologic Model for End Stage Liver Disease (MELD) ≥10. * Decompensated cirrhosis with active or history of variceal bleeding, ascites, hepatic encephalopathy, or jaundice. * Potential transplant candidate as per UAMS criteria Exclusion Criteria: * Large gastric or esophageal varices with contraindication to use beta-blockers. * Persistent hepatic encephalopathy grades 2-4. * Prior diagnosis of hepatocellular carcinoma, or hepatic hydrothorax (with prior repeated thoracocentesis). * Cirrhotic cardiomyopathy or congestive heart failure, pulmonary vascular complications, known active coronary artery disease, syncope, and cardiac dysrhythmias. * Physical impediment to perform a cardiorespiratory fitness test. * Use of implantable defibrillator or a pacemaker.