Issue Highlights

Early use of transjugular intrahepatic porto-systemic shunts (TIPS) is an option for patients with acute variceal bleeding who are at a high risk of re-bleeding and death, but there is a concern about identifying the right patients for early TIPS. In this large multicenter international study, Conejo et al. examined three different criteria for risk stratification in 5 patients presenting with acute variceal bleeding.1 These criteria included: a) patients with Child B cirrhosis with active bleeding at endoscopy and all Child-Pugh C patients; b) patients with a MELD score or 19 or higher; and c) Child C patients with plasma creatinine ≥ 1 mg/dl at admission.

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