Since your varices continue to bleed despite multiple EVL sessions, your portal hypertension is severe and needs advanced intervention. Key next steps include: TIPS (Transjugular Intrahepatic Portosystemic Shunt): A radiologic procedure to lower pressure in your portal vein, which is highly effective for refractory bleeding. Medications: Non-selective beta-blockers (like Carvedilol) to reduce portal pressure, and iron supplements or blood transfusions for your low haemoglobin. Liver Transplant Evaluation: This is the definitive treatment for decompensated cirrhosis. Please consult your gastroenterologist or a transplant hepatologist immediately to discuss these life-saving options.