HepQuant to Predict Hepatic Encephalopathy After TIPS

Inclusion Criteria: * Subjects over the age of 18 able to provide consent * Subjects undergoing initial TIPS procedure for the primary indication of treatment of ascites Exclusion Criteria: * Prisoners * Pregnant women * Subjects undergoing TIPS placement as part of an investigational study outside of usual clinical care * Subjects taking beta-blocker medications or angiotensin converting enzyme inhibitors * Subjects with evidence of porto-systemic shunts present on imaging (eg splenorenal shunt) * Subjects with calculated MELD score \>12 based on most recent laboratory values before consent * Subjects with prior history of overt hepatic encephalopathy (grade 3-4) that was primary reason for hospitalization. Episodes of hepatic encephalopathy that were the consequence of other precipitating event (such as variceal bleeding or infection) will not be considered exclusionary. * Subjects with a known sensitivity to albumin preparations, any ingredient in the formulation, or components of the container * Subjects unable to fast for \>5 hours prior to the HepQuant administration or subjects who are unable to drink the oral dose of the cholate (\~40mL of liquid).