As you have been diagnosed with cirrhosis you really need to be under the care of a hepatologist associated with a transplant center. Such a doctor would be best able to guide you with treatment questions I’m not sure you are getting good advise. Not sure how a TIPS procedure would even be under discussion at this point seems very premature to me bearing in mind I am not a medical professional I’m just a patient like yourself.
Why are you taking a beta blocker how were you diagnosed with portal hypertension?
My MELD is 6 I was diagnosed with cirrhosis with liver biopsy in 2008. In 2012 I had developed esophageal varicies which I had banded because I could not take a beta blocker as the goal of beta blocker treatment is to reduce heart rate below 60 bpm and my heart rate is already lower than that.
Anyway my suggestion is to see a different doctor for a second opinion specifically a hepatologist who is working in a liver transplant practice. That is the kind of doctor I have been seeing.
Found some info
Reasons to have TIPS performed:
“Accepted indications for TIPS include the following:
Uncontrolled variceal hemorrhage from esophageal, gastric, and intestinal varices that do not respond to endoscopic and medical management.
Hepatic pleural effusion (hydrothorax)”
Reasons to NOT have TIPS performed:
“Contraindications for TIPS
Primary prevention of variceal hemorrhage.
Congestive heart failure.
Severe pulmonary hypertension.
Severe tricuspid regurgitation.
Active biliary obstruction.
Multiple hepatic cysts or Caroli's disease.”
Per above it is not used to prevent variceal bleeding it is used to treat uncontrolled variceal bleeding that cannot be controlled by endoscopy and medical management.
I would get a second opinion
My doctor believes the improving platelet count is a sign my liver is improving post treatment. I don’t personally know anything about embolization.
You don’t have to wait for your doctor to retire. You are the customer if you don’t like your doctor vote with your feet is my suggestion. If you have bad service at a store or restaurant do you go back?
Or just go to the Mayo if that is an option then you are at an entirely different practice.
You don’t have to accept a doctor you don’t like working with. Just my thoughts....
I found numerous articles on treating rectal varicies none of which reference TIPS
Try googling retail varicies treatment.
I would change to the Mayo
Well that would be a good question for your doctor associated with a transplant center. But I kind of think maybe no. They want your likely good of survival of the procedure to be likely for several years post.
You need a MELD of at least 15 to be listed and then you go through a health, psychological, and social assessment. Health as to the rigors of the procedure, psychological to assess the psychological impact on you of the procedure and the likelihood of your being capable of and willingness to be compliant with a lifetime of anti rejection drugs. And social you need to have a family member available full time during your initial recovery post treatment. Not all those with a MELD above 15 will be listed because of the above.
Also most transplants occur with a MELD score around 30 or higher due to the availability of organs. Transplants are allocated to the sickest patients first. So centers will have lower average scores depends on the availability of organs. I have read that at any given time there are about 6,000 people waiting for transplant and only about 1,600 performed annually. Sadly people die waiting for transplant.
With a MELD of 8 you are not eligible to be on the list. They want your odds of dying from liver disease to be higher than your odds of dying from the transplant.
At this point you want to work on being as healthy as possible our goal is to die from something other than liver disease. With cure of hep c we do have the possibility of our livers improving with time. They say about 50% of people with cirrhosis before curing hep c may regress to lower fibrosis scores. It all depends on how much damage had already occurred before cure and how we treat our livers post hep c. So like for myself my BMI is a little high and I’m getting indications of fatty liver I need to get down to a normal weight to prevent additional liver damage from fatty liver. So a good diet and exercise as tolerated and allowed by our doctors is what we need to do if we want to live a normal life span. Of course this is just general information and may not apply to your situation.