Dear Anand!
Many thanks for the query.
I have gone through your mail in detail and could grasp the slaient points regarding your mother's illness.
I understand that she has decompensated cryptogenic
cirrhosis. Her tense
ascites is troubling her and prevents her from lying on the bed comfortably and requires periodic removal of the fluid in the abdomen.
TIPS is a good and acceptable procedure for intractable ascites and gives good comfort to the patient. this procedure should ideally be done in a center experienced in TIPS. There will be increased urination but there will not be any loss of protein through the urine.
Hypoproteinemia ( low protein in the blood) is essentially due to decreased production of proetin by the diseased liver. TIPS is not a life thretening procedure but can cause hepatic encephalopathy(altered sensorium / irrelevant actions and talk etc..) over a period of time and occassionally this TIPS
stent can get blocked. You need to check with your hepatologist whether she is a candidate for an early
liver transplantation. If so you can wait for a while before TIPS.
Regards