Prognostic Factors for Post-Transjugular Intrahepatic Portosystemic Shunt Creation Liver Failure and Death.

Transjugular intrahepatic portosystemic shunt (TIPS) creation may result in post-TIPS liver failure (PTLF). In this single-center retrospective study, PTLF was graded using a classification system that allows clinicians to characterize morbidity and mortality from TIPS-related hepatic insufficiency, and prognostic factors for PTLF were assessed. A total of 559 patients who underwent TIPS creation from 1998 to 2025 were included. The overall incidence of PTLF was 17%, and the incidence of Grade 3 PTLF (post-TIPS liver insufficiency-related death) was 6%. Model for End-stage Liver Disease (MELD) score was a predictor of PTLF (area under the receiver operating characteristic curve [AUROC], 0.637 for PTLF Grades 1-3; AUROC, 0.785 for PTLF Grade 3), and an MELD score exceeding 16 was identified as a cutoff for increased risk.