Liver Tumors and Fluid Build-up in Abdomen

My father is 92 with pacemaker for chronic heart failure, had a liver tumor removed by radio frequency ablation, but continues to have fluid build-up in his abdomen and one lung.  What can be done to eliminate fluid build-up?  Have read about TIPS - Transjugular Intrahepatic Portosystemic Shunt.  Is this an option for my father with his conditions?

[Thomas D Schiano, MD]

TIPS is definitely not an option due to his age.  he will need diuretics and a periodic tap of the lung or the abdomen.  TIPS would be very dangerous for him and could cause encephalopathy.

[rosend6]

What can be done for my father about the constant fluid build-up in his abdomen and lung since you have said TIPS is not an option?  He is on diuretics anyway, which do not seem to help much and he is getting periodic fluid taps every three-four weeks.  I thought Tips is supposed to stop fluid build-up by enhancing the way the blood flow in the liver would work.

[Thomas D Schiano, MD]

TIPS can help manage ascites but is works much less effectively in older individuals.  in addition, there is a significant risk for incapacitating encephalopathy.  periodic taps may be the best option.  I am afraid that the TIPS could hurt him.