Outpatient Transplant Liver Biopsy
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. If you have any questions you can call the Transplant Clinic at (608) 262-5420.
What Is a Transplant Liver Biopsy?
If your liver blood tests are going up, your doctor will often want to do a biopsy of your liver. This could be due to acute or chronic rejection, obstruction or other liver problems. A small piece of tissue will be removed and looked at under a microscope. A special needle is put through the skin and into the liver to obtain the liver tissue. Your skin will be numbed before the biopsy so that it should not be painful.
If you take any other blood thinners, for example, Coumadin® (warfarin) or Plavix® (clopidogrel), be sure to inform us when we schedule the biopsy. We need to stop these before the biopsy. However, blood thinning pills should never be stopped without discussing this with the doctor who prescribes it for you. These are some general guidelines:
• Coumadin® (warfarin) or Plavix® (clopidogrel) should be stopped 5 days before the biopsy.
• Effient® (prasugrel) should be stopped 7 days before the biopsy.
• Pradaxa® (dabigatran) should be stopped 2 days before the biopsy.
Again, we do not want to stop any of these medicines without first talking to the doctor who prescribed them for you.
The biopsy takes less than fifteen minutes, but plan to spend most of the day in the clinic.
How to Prepare for Your Liver Biopsy
1. If you can, please avoid taking aspirin or aspirin products seven (7) days before the biopsy. Also avoid taking other drugs such as ibuprofen, Advil®, Motrin®, Naprosyn®, and Feldene®.
2. You will not be able to drive home after the biopsy. You MUST bring a driver with you. You should not drive or make important personal or business 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.
3. You will be resting on a cart for four (4) hours after the biopsy. 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.
4. Do not eat any solid foods after midnight on the night before the biopsy. You may have clear liquids for breakfast. If you have diabetes, please ask the clinic staff or your doctor about your insulin dose for that morning.
5. You may take your morning medicines unless you are told not to. If you are having a cyclosporine or tacrolimus level drawn that day, please bring the dose with you so you can take it after the blood is drawn.
6. If you are an HMO member, you will need a referral. You can call the Transplant Clinic if you have questions about this.
The Morning of the Biopsy
1. Please report to the 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 clotting factors are within the normal range. You will also have an IV started at the lab when they draw your blood.
2. Next, report to the Transplant Clinic. You will be told about the biopsy, its purpose and risks, and then asked to sign a consent form. You will get fluids through your IV.
3. After all of the lab results are back and have been reviewed, you may be given oral medicine to help you relax. The biopsy will be done in X-Ray using ultrasound. Patient Escort Staff will take you to and from X-Ray on a cart.
After the Biopsy
1. You will remain on a cart in the recovery area and lie quietly for four (4) hours. Nurses will watch closely for any problems. Your family may join you in the room during this time.
2. The biopsy site will be covered by a Band-Aid®. It will also have a sandbag on it for the first hour.
3. You will have nothing to eat or drink for 1-2 hours and then we will give you lunch. If you are on a special diet, please let the nursing staff know when you arrive in the clinic.
4. We should have the results of the biopsy before you leave, and we will talk with you about your plan of care. Depending on the resuls, 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.
5. About three hours after the biopsy, a blood sample will be taken to check your hematocrit. Once it is stable, you have rested for four hours, and have gone over the home care instructions, you can then leave with your driver.
6. The nurse or your coordinator will review any changes in your medicines and instructions for getting your blood drawn before you leave.
1. Plan quiet activities when you get home. No driving or drinking alcohol for the rest of the day.
2. 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.
3. You should not do any heavy lifting (greater than 10 pounds) or other strenuous activity for three (3) days after the biopsy.
When to Call
Please call if you have sharp abdominal pain, feel dizzy or have a fever greater than 100° F.
(608) 262-5420 Monday-Friday
8:00 a.m. - 5:00 p.m.
(608) 263-6400 Nights and Weekends
Ask for the Transplant Coordinator on call. Give the paging operator 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.
If you live out of the area
1-800-323-8942. Ask for the Transplant Clinic.
The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.
Last Updated: 01/25/2013
Copyright © 11/05/2012 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#4213
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