Endoscopic Intragastric Balloon Placement for Weight Loss in Liver Transplant Waitlist Candidates

Inclusion Criteria: * Adults with end-stage liver disease who are listed for liver transplant * Have failed the non-invasive approach to weight loss to be actively listed for transplant (requiring 2 clinical return visits without weight loss of \>5 kg) * Body Mass Index (BMI) \>35 * Negative pregnancy test for females who are able to get pregnant and are of child-bearing age Exclusion Criteria: * A previous history of gastric or bariatric surgery * Current or recent (within 6 months) gastric or duodenal ulcers * Moderate to severe Portal hypertension defined as portal gastropathy graded as \>= to moderate/severe, gastric varices, or esophageal varices graded \> = moderate/large (Patients with varices which have been obliterated may be included). * Calculated Model of End-stage Liver Disease (MELD) score \>25 or childs score \>10 * The presence of more than one gastric balloon at the same time * Any inflammatory disease of the gastrointestinal tract including esophagitis, gastric ulceration, duodenal ulceration, cancer or specific inflammation such as Crohn's disease. * A large hiatal hernia or \>5 cm hernia or ≤5 cm with associated severe or intractable gastro-esophageal reflux symptoms. * A structural abnormality in the esophagus or pharynx such as a stricture or diverticulum that could impede passage of the delivery catheter and/or an endoscope. * Achalasia or any other severe motility disorder that may pose a safety risk during removal of the device. * Gastric mass * Severe coagulopathy * Patients who are known to have or suspected to have an allergic reaction to materials contained in ORBERA. * Serious or uncontrolled psychiatric illness or disorder that could compromise patient understanding of or compliance with follow up visits and removal of the device after 6 months. * Alcoholism or drug addiction * Patients who are unable or unwilling to take prescribed proton pump inhibitor medication for the duration of the device implant * Patients unwilling to participate in an established medically-supervised diet and behavior modification program, with routine medical follow-up. * Patients receiving aspirin, anti-inflammatory agents, anticoagulants or other gastric irritants, not under medical supervision.