Efficacy and Safety of Combination Ambrisentan and Tadalafil in Patients With Portopulmonary Hypertension

Inclusion Criteria: * Child-Pugh Class Class A \& B Cirrhosis * mPAP ≥35mmHg * Pulmonary Capillary Wedge Pressure (PWCP) \<15mmHg on Right Heart Catheterization's (RHCs) * mPAP \> 50mmHg will be considered eligible unless they are World Health Organization (WHO) Functional Class IV Exclusion Criteria: * End stage renal disease on hemodialysis (ESRD on HD) * Renal dysfunction and GFR \< 30 * AST, ALT \> 5 times the upper limit of normal * Total bilirubin ≥ 6.0 * INR \> 2 * Initially, Child-Pugh Class C patients will be excluded; however, after the first 5 patients are included, if there is no signal of worsening liver function, the protocol may be amended to include patients with Class C cirrhosis.