Level 1: Hospital name University College Hospital

Having a Liver Biopsy Imaging Department

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If you would like this document in another language or format, or require the services of an interpreter, contact us on:

020 3447 0242. We will do our best to meet your needs.

Contents Page

1. Introduction 3

2. What is a liver biopsy 3

3. How can a liver biopsy help in your treatment? 3

4. What are the risks of liver biopsy? 3

5. Can I refuse to have the biopsy? 3

6. How should I prepare for liver biopsy 4

7. Asking for consent (permission) 4

8. What Happens during a liver biopsy? 5

9. Will I feel any pain? 5

10. What should I expect after liver biopsy 5

11. When will I get my results 6

12. Research biopsies 6

13. Where can I get more information? 6

14. Contact details 7

15. How to find us & transport 7

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1. Introduction

This booklet tells you what you need to know before having a liver biopsy. It explains what is involved and the possible risks.

2. What is a liver biopsy?

A liver biopsy is a test where a very small piece of tissue is removed from your liver with a needle through the skin. A specially trained doctor called an interventional radiologist performs liver biopsies at UCH.

3. How can a liver biopsy help in your treatment?

The results of the biopsy will help your doctors make a more accurate diagnosis and guide your future treatment.

4. What are the risks of liver biopsy?

The main risk is of damage to blood vessels and bleeding as the needles are inserted. A small amount of bleeding around the site is normal and this will resolve without treatment. Approximately 1 in 200 people will have serious bleeding requiring a blood transfusion. Rarely, you may require an

operation, and very rarely, death can occur from bleeding. It is reported that 1 death occurs for every 10,000 liver biopsies that are performed. This risk is higher (1 in 1,000) when we biopsy a liver tumour.

Rarely, other organs like the lung, gallbladder or bowel can be damaged.

5. Can I refuse to have the biopsy?

If you do not want to have the biopsy, please discuss this with your doctor.

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6. How should I prepare for liver biopsy?

You will need to have a blood test about 1 week before the biopsy as there is an increased risk of bleeding after the procedure. Your doctor will tell you about this test and how to arrange it when they book your liver biopsy.

Unfortunately, if you do not have your blood tests before the biopsy date, your biopsy will be cancelled.

You must not eat or drink for six hours before the liver biopsy. However, you can continue your regular medications and take sips of clear fluid during this time.

Please arrive 30 minutes before your appointment time. You will be given a hospital gown to wear during the biopsy. You will need to arrange for someone to take you home by car or taxi, although in some cases, patients will be admitted overnight.

7. Asking for your consent (permission)

Before your biopsy we will ask you to sign a consent form saying that you understand the reasons and risks of this

treatment. If there is anything you don’t understand, or you need more time to think about it, it is important that you tell a member of staff.

If you are taking aspirin, warfarin, or other blood thinning medicine, you will need to stop these in advance of the liver biopsy. Aspirin is usually stopped 7 days before a liver biopsy. Clopidogrel™ is stopped 14 days before a liver biopsy. Please discuss the risks of stopping these medications with your doctor.

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8. What happens during a liver biopsy?

The doctor will inject anaesthetic to numb the skin. A special biopsy needle is used to remove a tiny piece of liver. This will only take a few seconds and should not hurt. This process may be repeated and you will hear a loud ‘click’ each time the needle takes a sample.

The wound is cleaned and a dressing is put over it. The whole process, takes approximately 30 minutes.

9. Will I feel any pain?

We reduce pain using local anaesthetic. You may have some abdominal or shoulder pain after the biopsy, but we can give you painkillers whenever you need them.

10. What should I expect after liver biopsy?

After the biopsy you will usually stay in our recovery area for 6 hours. However, some people may be required to stay overnight in hospital. We will ask you to lie still on your right side to help the healing process. While in the recovery area we will also check your blood pressure and heart beat.

You will need a responsible adult to take you home by car or taxi, and they will need to stay with you overnight. We do not recommend you use public transport as it may be unsafe if you

feel unwell.

Rest at home for 24 hours and do not go to work the day after the procedure. If you feel unwell or have pain after the biopsy, go to your nearest Accident and Emergency department.

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11. When will I get my results?

The results take about 7-10 working days and are sent to your referring doctor. You need to make an appointment with the doctor that referred you to pick up your results. We do not issue results over the telephone.

12. Research biopsies

Your doctor may ask you to be part of a research trial, which may mean you are asked to have a liver biopsy. The biopsy will provide information for the trial, but may not be of direct benefit to you. You should discuss this with your doctor.

Your consent for the biopsy is required. A research biopsy is exactly the same as a non-research biopsy and the risks are the same (see section 4).

13. Where can I get more information?

You can ask your hospital doctor at your appointment, or at the time of the biopsy, or, you can use the Internet to access the following websites:

British Liver Trust

www.britishlivertrust.org.uk

Royal College of Radiologists

www.goingfora.com

UCL Hospitals cannot accept responsibility for information provided by other organisations.

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14. Contact details

UCLH Interventional Oncology Service: 020 3447 0242

UCH Switchboard: 020 3456 7890

Hospital Transport Services: 020 3456 7010

Website: www.uclh.nhs.uk

15. How to find us & transport?

Please go the main ‘University College Hospital’ building with the entrance on Euston Road (see map on page 9). Take the lifts nearest Euston Road to the second floor, and follow the signs to Imaging Reception.

Travelling to the hospital

No car parking is available at the hospital. Street parking is limited and restricted to a maximum of 2 hours.

Please note the University College Hospital lies outside, but very close to the Central London Congestion Charging Zone.

Tube

The nearest tube stations, which are within 2 minutes walk are:

Warren Street (Northern and Victoria lines)

Euston Square (Hammersmith & City, Circle and Metropolitan lines)

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Overground trains

Euston, King Cross & St Pancras and Kings Cross Thames link railway stations are within 10-15 minutes’ walk.

Bus

Bus services are shown on the map on page 9.

Further travel information can be obtained from http://www.tfl.gov.uk 020 3054 4040

Hospital transport services

You will need to call at least 7 days before your appointment.

If you have a clinical condition or mobility problem that is unlikely to improve you will be exempt from the assessment process. However, you will still need to contact the assessment team so that your transport can be booked.

If your appointment is cancelled by the hospital or you cannot attend it, please call 020 7380 9757 to cancel your transport.

Can an escort be arranged to accompany me in hospital transport?

This will depend on your clinical condition or mobility. If you meet the criteria then an escort will be booked to accompany you to and from the hospital. However, we aim to keep these to a minimum as escorts take up seats that would otherwise be used for patients.

If you feel that you are eligible for transport please call: 020 3456 7010 (Mon to Fri 8am-8pm) to speak to a member of the Transport Assessment Booking Team.

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Space for notes & questions

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Authors: F. Pathiraja, S. Bandula, Z Amin, S. Read

First published: May 2016 Date last reviewed: may 2016

Date next review due: May 2018

Leaflet code: UCLH/S&C/ID/IMG/LB/1

© University College London Hospitals NHS Foundation Trust