A liver biopsy involves the surgeon removing a small piece of your liver (about 1/50,000th of your liver) to send for further tests. Most liver biopsies are examined under the microscope by a pathologist. Sometimes, a piece of liver is sent to microbiology to see if there is any infection in the liver. Your doctor will explain to you why he/she thinks you need a liver biopsy. A liver biopsy may be done to look for the cause of liver abnormalities, to assess if, and how much, the liver is damaged and/or to help in planning treatment.

You will need to be in hospital for at least 4-6 hours after the biopsy. This may require admission either overnight or may be done as a day case. Before the liver biopsy is done, the doctor or nurse will check your blood to make sure that clotting is within acceptable limits. If you are taking certain medicines, drugs or tablets that may affect bleeding and clotting you may be asked to stop them for a few days or a week or two before the biopsy. Sometimes, perhaps because of liver disease, the blood does not clot as well as is needed and you may be given some blood factors (plasma) to help your blood clot. Sometimes you may also need platelets to be given. If it is unsafe the doctor will not proceed with the biopsy.

You can ask the surgeon about having sedation before the biopsy. In order to give injected sedation, an extra nurse or doctor needs to be present to give you the injection and monitor you during the procedure therefore telling us in advance will help us plan for this. You may also be able to take a ‘relaxing’ tablet by mouth before the procedure.

• The vast majority of liver biopsies are done without any complication. The most common complication is pain and this can usually be controlled with pain killers. Bleeding is a potential problem, and for this reason the doctor will check that your blood clots normally and the nurse will take your blood pressure and pulse after the procedure. Bleeding may affect 1 in 200 liver biopsies.
• Often this settles by itself, but we know that 1 in 4 patients who bleed may require a blood transfusion. Very rarely (perhaps less than 1 in 500 of the patients who have this problem) an operation is required to stop the bleeding.
• As the doctor is unable to see the whole liver when performing a biopsy, there is the possibility that the needle might injure other organs, such as the gall bladder or, very rarely, the kidney or bowel. This happens in less than 1 in 1000 cases. Sometimes, needle injury to other organs does cause problems, however very severe complications are extremely rare.