Liver Biopsy

What is a liver biopsy?

A liver biopsy is a procedure in which a very small sample of liver tissue is taken using a special needle. The sample is examined under a microscope to determine the exact nature of the liver disease, the activity of inflammation, the degree of fibrosis (scarring) or other changes.

Liver biopsy is now performed much less frequently than in the past because, in many cases, the condition of the liver can be assessed using non-invasive tests such as elastography, blood tests or magnetic resonance imaging. However, in certain cases, biopsy remains the most accurate diagnostic method and can help establish a definitive diagnosis or select the most appropriate treatment.

When is a liver biopsy performed?

A liver biopsy may be recommended:

• when the cause of liver disease cannot be determined accurately;
• when autoimmune, metabolic or rare liver diseases are suspected;
• to assess the degree of liver inflammation or fibrosis;
• when imaging or laboratory tests do not provide sufficient information;
• when a liver lesion or changes following transplantation need to be assessed.

How should I prepare for a liver biopsy?

• You will usually be asked not to eat or drink for 6–8 hours before the procedure.
• Before the biopsy, blood tests will be carried out to assess blood clotting and your platelet count.
• If you take medicines that affect blood clotting, such as warfarin, apixaban, rivaroxaban, dabigatran, clopidogrel or others, you must inform your doctor. Do not stop taking any medicines without medical advice.
• Tell your doctor about any allergies, pregnancy and other significant medical conditions.

How is the procedure performed?

• The procedure is usually performed under ultrasound guidance.
• The skin and tissues beneath it are numbed using a local anaesthetic.
• A small sample of liver tissue is taken using a special needle.
• The biopsy itself takes only a few seconds, while the entire procedure usually takes 20–30 minutes.

After the procedure

• Following the biopsy, the patient is monitored at the healthcare facility for several hours. In some cases, an overnight hospital stay may be recommended.
• You should avoid physical exertion and lifting heavy objects on the day of the procedure.
• If you experience severe abdominal or right shoulder pain, dizziness, weakness, fever or signs of bleeding, seek medical attention immediately.

Is a liver biopsy safe?

Liver biopsy is a commonly performed and generally safe procedure. The most common complication is temporary pain at the biopsy site or in the right shoulder. More serious complications, such as bleeding or injury to nearby organs, are rare. Before the procedure, your doctor will explain the potential benefits and risks and answer any questions you may have.