Inclusion Criteria:  adult (aged 18 years and older) diagnosis of cirrhosis (MELD<25) according to biopsy, imaging, elastography, or other fulfill the guideline-based prophylaxis in place for high risk gastroesophageal varices able to communicate (e.g., speak, read, and write) in English provide informed written consent for self  Exclusion Criteria:  hepatocellular carcinoma (HCC) outside of the Edmonton liver transplant criteria previous myocardial infarction EF <50% ischemia on stress testing oxygen saturation <95% non-HCC malignancy end-stage renal disease. at the discretion of the healthcare team if a participant can participate in the pilot study