The goal of a new study published in the Journal of Gastroenterology and Hepatology was to identify predictors of Model for End-Stage Liver Disease-sodium score reductions and improvements in vital prognoses following portosystemic shunt occlusion in portal hypertension patients. During this study, 70 cirrhotic patients with major portosystemic shunts and a mean Model for End-Stage Liver Disease-sodium score of 10.5 underwent balloon-occluded retrograde transvenous obliteration between 2008 and 2017. In these patients, scores before and 1 month after shunt occlusion were calculated. The results showed that Model for End-Stage Liver Disease-sodium score did not significantly change, 1 month after balloon-occluded retrograde transvenous obliteration and the score decreased postoperatively in 44.3% of the patients. In addition, the decline in score after portosystemic shunt occlusion was strongly associated with hepatic encephalopathy as a procedural indication, lower liver volumes, and lower liver stiffness levels measured by transient elastography before treatment. Furthermore, preoperative liver stiffness level was identified as an independent predictor of Model for End-Stage Liver Disease-sodium score amelioration following balloon-occluded retrograde transvenous obliteration. A liver stiffness cutoff value of 21.6 kPa was determined, with a sensitivity of 76.0% and specificity of 69.6%. It was also noted that the overall survival rates after treatment in patients with liver stiffness <21.6 kPa were significantly higher than in those with liver stiffness ≥21.6 kPa. Hence, it was concluded that liver stiffness measured by transient elastography may predict improvements in Model for End-Stage Liver Disease-sodium scores and in survival rates after portosystemic shunt occlusion in portal hypertension patients.