North American Study for the Treatment of Refractory Ascites (NASTRA)

Inclusion Criteria: * Cirrhosis as documented by biopsy or clinical/laboratory parameters WITH * Tense symptomatic ascites and need for paracentesis (10 L) within last 2 months AND * Failure of medical therapy as defined by the inability to lose at least 3.3 lbs/week while on maximum doses of diuretics or diuretic related complications (severe hyponatremia, hypercalcemia, azotemia or encephalopathy) Exclusion Criteria: * Causes of ascites other than cirrhosis and portal hypertension * Terminal liver failure * Portal vein thrombosis * Congestive heart failure * Acute renal failure * Active encephalopathy * Alcoholic hepatitis * Pregnancy