Liver Biopsy In Children

Key points about liver biopsy in children 

• a liver biopsy involves taking a very small sample of liver tissue
• this is done using a needle
• your child will have an anaesthetic to put them to sleep during the procedure
• the tissue can be sent to the lab to test for certain medical conditions
• your child will have an anaesthetic to put them to sleep during the procedure

What is a liver biopsy?

A liver biopsy involves taking a small piece of liver tissue using a needle that's inserted into the upper tummy. This procedure is done at the hospital. Your child will have an anaesthetic medicine to put them to sleep during the procedure. 

A gastroenterologist or radiologist will perform the liver biopsy. A gastroenterologist is a doctor who specialises in conditions that affect the liver and digestive system. A radiologist is a doctor who can diagnose and treat medical conditions using imaging methods like x-rays, ultrasound scans and MRI scans.

Reasons for needing a liver biopsy

Tamariki (children) may need a liver biopsy for different reasons.

Diagnose a medical condition

A liver biopsy can help to diagnose if there are certain conditions affecting your child’s liver. It can also help doctors to understand how much damage there is in the liver.

Monitor the liver 

If your child has an ongoing liver condition, they may need a biopsy to monitor the liver. Liver biopsies help doctors to see if certain treatments are working and are also used for monitoring after a liver transplant. 

Preparation for a liver biopsy

Fasting 

Your child will not be able to eat for a period of time before their procedure. Check their appointment letter for instructions on when they need to stop eating and drinking, as this may be the day before their biopsy. 

Blood test

The doctors will need to have recent blood test results available. Your child will need a blood test in the week leading up to their biopsy. You won’t necessarily need to go into the hospital for this blood test, it can be done at a blood lab close to you. This is to check your child is in good health to go ahead with the procedure.

What happens during a liver biopsy

Fasting 

Your child will not be able to eat for a time period before their biopsy. They can have clear fluids up until a certain time. Check your child’s appointment letter for instructions on when they need to stop eating and drinking.

Anaesthetic 

Your child will have an anaesthetic to put them to sleep during the procedure. 

Your child may also have some local anaesthetic put into the skin. This can help numb pain sensations around the area where the needle goes in.

See the KidsHealth page on anaesthetic for more information.

Liver ultrasound 

Tamariki will need an ultrasound scan of their liver during the biopsy. This shows the doctor the best place to take the biopsy and makes sure the procedure is done as safely as possible.

Procedure

The doctor will make a small incision (cut) in your child’s tummy and then insert the biopsy needle. This cut is small and usually doesn’t require any stitches afterwards. 

The doctor will take 1 to 2 small samples of liver tissue through the needle. This procedure usually takes up to 30 minutes but can take longer. 

Recovery

After the procedure, your child will go to a recovery area where you can join them. Once they are allowed to, they can start drinking fluids and then food when they feel ready. 

What happens after a liver biopsy

Bed rest

Your child must rest in bed for 6 hours after their procedure. They can get up to go to the toilet with supervision. After 6 hours, they can start walking gently and slowly.

Going home after a liver biopsy 

Your child will be closely monitored at the hospital for around 6 hours after their biopsy. The doctor or nurse will then review them. Plans can be made to go home when your child is ready. In some cases, and depending on the timing of the procedure, your child may need to stay overnight at the hospital. 

Liver biopsy results

The small liver tissue samples will be sent to the lab to be looked at. It can take a few weeks to get these results, depending on what is being tested. The doctor or nurse will make a plan with you before you leave the hospital on how to follow up on these results. They may ask you to contact your child’s GP clinic after a few weeks if you haven’t had any results back. 

Care for your child at home after a liver biopsy 

Once your child is home, they can return to school or childcare the next day. 

Tamariki should not do any contact sports or vigorous activity for 1 week after their liver biopsy.

Leave your child’s dressing on for 2 days or until it falls off naturally. 

Possible side effects from having a liver biopsy

The doctor will talk to you about any potential side effects before your child has their procedure.

Infection

There is a small risk of infection following a liver biopsy. Your child’s doctor will let you know what to look out for.

Ongoing bleeding

There is a small chance of bleeding after this procedure. A dressing will be placed on your child’s tummy where the cut is. The dressing must stay on for 2 days after the biopsy. 

Pain

Some tamariki may experience some discomfort or pain after their biopsy. Your child’s doctor will give you medicine to help with pain if your child is uncomfortable.

When to get medical help after a liver biopsy 

You should contact the hospital or take your child to see a doctor if they:

• have tummy pain or bloating that is ongoing and worsening
• have ongoing bleeding from the biopsy site
• have a fever (temperature over 38 degrees Celsius)
• appear unwell, or you are worried 

If you have concerns or your child has side effects that are not settling, take them to see the doctor.