Final answer:
TIPS is typically avoided in patients with a MELD score greater than 18, as higher scores correlate with increased risk. The best outcomes for TIPS are seen in patients with a MELD score below 15, allowing for safer management of portal hypertension with lower mortality risk.
Step-by-step explanation:
The Transjugular Intrahepatic Portosystemic Shunt (TIPS) procedure is often avoided in patients with a Model for End-Stage Liver Disease (MELD) score greater than 18. Patients with a MELD score of less than 15 are associated with the best outcomes when undergoing TIPS. This scoring system helps assess the prognosis and the severity of liver disease, where a higher score indicates more advanced liver disease and a higher risk of mortality.
The MELD score is used by clinicians to determine the urgency of liver transplantation and to prioritize patients for receipt of a liver graft. The score is calculated based on several blood test results, which include bilirubin, creatinine, and the International Normalized Ratio (INR) for prothrombin time. Due to the increased risks associated with higher MELD scores, the benefits and risks of the TIPS procedure must be carefully considered. In patients with lower MELD scores, TIPS can effectively decrease portal hypertension and associated complications, such as variceal bleeding or refractory ascites, with an acceptable risk profile.