After transplant, your child's doctor may order a biopsy to determine if the cause of elevated liver enzymes is rejection. During a liver biopsy, the doctor will take a small piece of the liver so it can be examined under a microscope. Before pediatric liver transplant, a biopsy can help determine the cause of chronic liver disease, as well as cellular changes and the degree of damage in the liver.
Your child may have a liver biopsy if he's already in the hospital. If you child isn't hospitalized at the time of the biopsy, it will be done on an outpatient basis, but he may stay overnight for observation.
Your child will have nothing to eat or drink for four to six hours before the biopsy, but will receive fluids through an intravenous (IV) line. He'll undergo blood tests, as well as an ultrasound, which helps the doctor pinpoint the exact location of the liver. Right before the test, a nurse will check your child's heart rate, breathing and blood pressure and listen to his lungs. Then the doctor will give your child medication via the IV line to make him or her sleepy. Your child may or may not fall asleep.
Your child will then go to a procedure room. A caregiver will wash your child's skin with a special brown soap, then inject a small amount of numbing medicine under the skin. Your child probably won't feel anything due to the sedation; if he does, he won't remember it later. Once the area is numb, the physician will carefully insert the biopsy needle into the liver; at this point, your child will feel pressure. The procedure will be over in less than five minutes. Afterward, the doctor will put a small adhesive bandage on the biopsy site to prevent bleeding.
After your child returns to his room, he may be sleepy, sore and nauseated. He'll need to lie quietly for four to six hours, and be limited to quiet activities after that. The nurse will monitor your child's vital signs and draw more blood tests. Once your child is awake, he can have clear liquids and progress to solid foods as he can tolerate them. The day after the liver biopsy, the bandage will be removed.
Liver biopsy results may be available the same day depending on what tests are ordered. Some test results may take several days and your child's doctor will talk to you about them.
Reviewed by: Elizabeth B. Rand, MD
Date: November 2012