Copper Supplementation in Cirrhosis

Inclusion Criteria: 1. Adult patients age 18 or older with confirmed diagnosis of cirrhosis based on clinical history, exam, imaging, laboratory or histological criteria; 2. Cirrhosis patients whose serum or plasma Cu are below the normal range (80-155 ug/dL for women and 70-140 ug/dL for men); 3. Cirrhosis patients whose serum or plasma Cu are in the normal range but exhibit at least one clinical feature that has been associated with Cu deficiency. These include history of infections, unexplained anemia, severe leukopenia, iron overload, unexplained neurological symptoms such as ataxia or myelopathy, coagulopathy with spontaneous bleeding. Patients must meet inclusion criteria 1 AND 2, or 1 AND 3 in order to be considered for the trial Exclusion Criteria: 1. Patients with Wilson disease, cholestatic liver diseases including primary biliary cholangitis and primary sclerosing cholangitis, all of which are associated with Cu overload; 2. Patients with fulminant hepatic failure; 3. Renal failure with a creatinine clearance \<25 ml/minute; 4. Hepatic encephalopathy more than grade 2 (Hepatic Encephalopathy in Chronic Liver Disease, 2014); 5. MELD score \>25 to minimize subject dropout due to been too ill; 6. Serious non-liver related medical illnesses such as cardiopulmonary and renal diseases and non-liver malignancies; 7. Active alcohol use; 8. Pregnancy