What Is a Liver Biopsy?

A liver biopsy is done using a long needle inserted between two of the right lower ribs to remove a sample of liver tissue. The tissue sample is sent to a laboratory and looked at under a microscope to see if there are any liver problems.

Why It Is Done?

A liver biopsy may be done to:

  • Find the cause of jaundice. A liver biopsy can find certain liver diseases (such as cirrhosis), infections (such as hepatitis), and liver tumors.
  • Find the cause of abnormal liver blood test results. These include aspartate aminotransferase (AST) and alanine aminotransferase (ALT). Both ALT and AST levels show liver damage and can help confirm liver disease.
  • See how much the liver is inflamed or scarred by hepatitis or other liver diseases.
  • See whether other liver conditions, such as hemochromatosis and Wilson’s disease, are present.
  • Check the response to treatment for liver disease.
  • Measure whether a medicine, such as methotrexate, is causing a toxic effect on the liver.
  • Check the function of a transplanted liver.
  • Find the cause of an unexplained and ongoing fever.
  • Check a liver mass found on an X-ray, ultrasound, or CT scan.

How To Prepare

If you take insulin, check with your doctor about what you need to take on the day of your test.

During the Test

Before the test, you may be given a sedative through a vein (IV) in your arm. The sedative will help you relax and remain still. During the test, you will lie on your back with your right arm resting under or above your head and your head turned to your left. Your doctor may tap on your chest and belly to find your liver or he or she may use ultrasound.

Your doctor will mark a spot between two of your right lower ribs where the biopsy needle will be inserted. The site will be cleaned with a special soap and draped with sterile towels. The doctor will give you a medicine (local anesthetic) to numb the area where the biopsy needle will be inserted.

You may be asked to take a deep breath, blow all the air out, and then hold your breath while the biopsy needle is being inserted and withdrawn. This will take only a few seconds. Holding your breath lowers the chance that the needle will go in your lung since the lungs are very close to the liver. It is important to remain still during the few seconds it takes for the doctor to collect the tissue sample. The doctor may take another tissue sample from the same spot, but from a different angle.

As soon as the doctor removes the needle, you can breathe normally. A bandage will be put on the puncture site. The test generally takes 15 to 30 minutes.