You are going to have a biopsy in the Transplant Clinic. This handout will explain what is going to happen, how to get ready, and what you will do after the biopsy.
Transplant Liver Biopsy
If your liver blood tests are going up, your doctor may want to do a biopsy of your liver. This test can help us figure out if you have acute or chronic rejection, obstruction or other liver problems.
A biopsy is a type of test that involves taking a small piece of tissue from the liver and looking at it under a microscope. A needle is put through the skin and into the liver to take the sample. Your skin will be numbed before the biopsy to reduce pain. The biopsy takes about 15 minutes but, the recovery takes longer. Plan to spend the rest of the day in transplant clinic.
Stopping Blood Thinning Medicines
Let us know if you take any blood thinners when we schedule the test. You will need to stop these before the biopsy. Never stop blood thinning pills without talking with your doctor first. You will be told when to stop these medicines.
Example: If you need to stop taking medicine 3 days before surgery, you count backwards 3 days from the test day (do not include the test day in your count). If your test is on a Thursday, stop taking your medicine on the Monday before your test.
Do not stop any blood thinners without first talking to your doctor.
Getting Ready for Your Liver Biopsy
Medicines: Stop taking your blood thinners as directed.
Transportation: Arrange for someone to drive home after the biopsy. You should not drive or make important decisions until the next day. If you plan to stay in a hotel after the biopsy, you will need to have someone to stay with you.
Clothing: We suggest you wear loose, comfortable clothes. You may also want to bring a book to read or some other quiet project to do while you are resting after the test.
Diet: Do not eat any solid foods after midnight the night before the test. You may have clear liquids for breakfast. If you have diabetes, talk with your doctor about your insulin or oral medicine dose for the night before and the morning of the test.
Referral: If you are an HMO member, you will need a referral.
The Morning of the Biopsy
Medicines: You may take your morning medicines unless you are told not to. If you are having a cyclosporine or tacrolimus level drawn the morning of the biopsy, please bring the dose with you. You can take it after your blood draw.
Labs: Please go to the hospital lab at 8:00 am (unless you have been told to arrive at a different time). Your orders will be in the lab. This will include a test to make sure that your blood clotting factors are within the normal range.
Transplant Clinic: Next, go to the Transplant Clinic. You will have an IV started. You will get fluids through your IV.
Consent: You will also be told about the biopsy, its purpose and risks. You will then be asked to sign a consent form.
Biopsy: After all the lab results are back and reviewed, you may be given oral medicine to help you relax. The biopsy will be done using an ultrasound.
During the Biopsy
Your skin will be numbed. Then, we will insert a needle through the skin and into the liver. We will then take a sample of tissue from the liver tissue. The test takes less than fifteen minutes but plan to spend most of the day in the clinic.
After the Biopsy
Recovery: You will remain in the recovery area and lie quietly for 4 hours. Nurses will watch closely for any problems. Your family may join you in the room during this time.
Biopsy site: You will have a Band-Aid® covering the biopsy site. You will also have a sandbag on it for the first hour.
Diet: You will have nothing to eat or drink for 1-2 hours after the biopsy. Then you may have lunch. If you are on a special diet, please let the nursing staff know when you arrive in the clinic.
Results: We should have the results of the biopsy before you leave. We will talk with you about your plan of care. Depending on the results, you may be admitted to the hospital. If not, you will be able to leave when the doctor decides that you are ready. Please bring your medicines and an overnight bag with you, in case you need to stay.
Blood draw: About 3 hours after the biopsy, we will take a blood sample to check your hematocrit. This helps us monitor for bleeding after the biopsy.
Medicines: The nurse or your planner will review any changes in your medicines. If you need more medicine after the biopsy, it will be sent to your preferred pharmacy before you leave.
Going home: You may leave (with your driver) once you are stable, have rested for 4 hours and we have given you instructions for home.
Plan quiet activities when you get home. No driving for the rest of the day. Avoid any alcohol use, as always.
You may remove the bandaid from the site the next morning and take a shower. You may notice that the site is bruised or tender.
No heavy lifting (greater than 10 pounds – about a full gallon of milk) or other strenuous activity for 3 days after the biopsy.
When to Call
Please call if you have:
Sharp abdominal (belly) pain
Have a fever greater than 100° F
Who to Call
Monday-Friday, 8 am - 5 pm
(608) 262-5420 or (800) 323-8942
Nights and weekends call 608-263-1384 to reach the paging operator. Ask for the Transplant Coordinator on call. Give your name and phone number with the area code. The Transplant Coordinator will call you back. Tell the Transplant Coordinator you had a liver biopsy and what problems you are having.