see Medscape article
“Indications
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 [4]
Refractory ascites
Hepatic pleural effusion (hydrothorax)
Controversial indications for TIPS include the following:
Bridge to transplantation and retransplantation
Budd-Chiari syndrome
Hepatorenal syndrome (HRS)
Veno-occlusive disease (VOD)
Contraindications
Absolute contraindications for TIPS include the following:
Severe and progressive liver failure (on the basis of the Child-Pugh score; scores A and B have a better outcome than score C)
Severe encephalopathy
Polycystic liver disease
Severe right-heart failure
Relative contraindications for TIPS include the following:
Portal and hepatic vein thrombosis
Pulmonary hypertension
Hepatopulmonary syndrome
Active infection
Tumor within the expected path of the shunt”