Table 3. Contraindications to placement of a TIPS.

Absolute	Relative
Primary prevention of variceal bleeding	Hepatoma, particularly if central
Severe congestive heart failure	Obstruction of all hepatic veins
Tricuspid regurgitation	Hepatic encephalopathy
Multiple hepatic cysts	Significant portal vein thrombosis
Uncontrolled systemic infection or sepsis	Severe uncorrectable coagulopathy (INR > 5)
Unrelieved biliary obstruction	Thrombocytopenia (< 20,000 platelets/mm3)
Severe pulmonary hypertension	Moderate pulmonary hypertension

Abbreviations: INR, international normalized ratio; TIPS, transjugular intrahepatic portosystemic shunt.