A liver biopsy is typically recommended by your liver transplant team when rejection is suspected. During a biopsy, your doctor obtains a very small sample of the transplanted liver tissue to examine under a microscope.

Preparing for the biopsy: What to Expect

• You will be given instructions from your child’s transplant team about what he/she is allowed to eat and drink before the biopsy. Your child most likely will not be allowed to eat or drink for the few hours before the procedure.
• Typically, a biopsy is performed by either your child’s transplant surgeon, hepatologist, or interventional radiology team. The doctor who will be doing the biopsy will speak to you before the biopsy is performed to answer any questions you may have.
• An anesthesiologist will also be present to ensure your child is sleeping and comfortable during the liver biopsy.
• Sometimes, an ultrasound is performed prior to the biopsy. During the ultrasound, a soft-tipped marker may be used to place an “X” on your child’s skin at the spot where the liver biopsy will be done.
• Your child will receive sedation or general anesthesia during the biopsy, as directed by the medical team. A needle is passed quickly through the skin and into the transplanted liver to take out a very small sample of liver tissue. The tissue is examined under a microscope by a pathologist and members of your child’s transplant team. This allows the team to determine both the type (acute or chronic rejection) and severity (mild, moderate, or severe) of the rejection, and help guide necessary treatment.
• The liver biopsy itself takes only 20 to 45 minutes, but the entire appointment and time in the hospital will take several hours.
• After the biopsy, your child will need to lie flat and still for a period of time to ensure the biopsy site heals well. Your liver transplant team will let you know if your child needs to stay in the hospital overnight.
• The biopsy site may be sore or tender for a couple of days following the procedure.
• Preliminary results for the liver biopsy are typically available within 24 hours, and your liver transplant team will let you know how you will be notified with the results, and discuss potential treatment options if needed.

What is a parent or guardian’s role during a liver biopsy?

All liver transplant centers welcome a parent or guardian’s help and support during a liver biopsy. One of the most important roles of a parent or guardian is to help your child stay calm and relaxed before and after the liver biopsy. It is always recommended that you talk with your child about what to expect during a biopsy using developmentally-appropriate language. Explain to them in the best way you can and answer his/her questions honestly. It is okay to tell them if you don’t know the answer to a question, and to ask the team together. Another way to help your child stay calm is to bring things to comfort and distract your child before and after the procedure. Having items from home will help ease any anxiety they may have about a biopsy. Your team is here to help support you and your child through the biopsy procedure. Let your team know if there are special needs or requests that will help your family through the procedure, and ask questions if you are unsure what to expect or need more information.