This page tells you about the procedure known as a liver biopsy. It explains what is involved and what the possible risks are. It is not meant to be a substitute for informed discussion between you and your doctor but can act as a starting point for such a discussion.
Your procedure will take place in the Radiology department. The radiology department may also be called the ‘X-ray’ or ‘Imaging’ department. It is the facility in the hospital where radiological examinations are carried out, using a range of x-ray equipment, such as a CT (computed tomography) scanner, an ultrasound machine and a MRI (magnetic resonance imaging) scanner.
A liver biopsy procedure 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.
There are many causes of liver disease, and it is sometimes difficult to diagnose and work out the best treatment using other tests such as non-invasive imaging techniques or blood tests.
The main reasons for a liver biopsy are to:
- help clarify diagnosis
- determine severity of liver damage or grade of tumour
- help predict prognosis in a person with a known diagnosis and inform treatment decisions.
- to support research.
The results of the biopsy will help your doctors make a more accurate diagnosis and guide your future treatment.
The consultants in charge of your care and the interventional radiologist performing the procedure have discussed your case and feel that this is the best option. However, you will also have the opportunity for your opinion to be considered and if, after discussion with your doctors, you do not want the procedure carried out, you can decide against it.
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 known to be higher (1 in 1,000) when we biopsy a liver tumour.
Rarely, other organs like the lung, gallbladder or bowel can be damaged.
You will need to have blood tests within a month of your biopsy appointment. These will include a blood test to establish your blood type and blood clotting tests. These will need to be performed at UCLH.
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 may be cancelled.
If you are taking a blood thinning medication such as Aspirin or warfarin these will need to be stopped in advance of your biopsy. Please discuss the risks of stopping these medications with your doctor.
You will be advised when to restart these medications by either your doctor or the doctor performing the biopsy. Patients taking warfarin/heparin will need a ‘bridging plan’ provided by the haematology clinic.
Examples for common blood thinning medications: [Ref: bsir-bsh-ir-bleeding-risk-guidance-2022.]
- Aspirin 5 days: (can be continued if considered high risk for stopping
- Clopidogrel: 7 days
- Apixaban/Rivaroxaban/Endoxaban: Omit 2 days prior
- Low molecular weight heparin (LMWH): Omit 1 day prior.
You will be informed at the time of booking if you are required to stay overnight.
If you are having a liver mass biopsy you will be admitted to the hospital overnight for observation. Please ensure you bring an overnight bag with you.
If you are NOT having a liver mass biopsy but a biopsy to assess the liver itself, you will be allowed home after you have completed your 6 hrs recovery in the department. You will need to arrange for someone to take you home by car or taxi and you will need someone to stay with you overnight. Please ensure these arrangements are made. If you do not have anyone to help you or if you live far away, please let us know as soon as possible so we can arrange an overnight bed for you.
On the day of your liver biopsy, you need to come to the Imaging Department at the time instructed on your appointment letter. You will be asked not to eat for 6 hours before your appointment time, though you can continue to drink clear fluids up to 2 hours prior to your appointment.
On arrival you will be checked into the department by a nurse. The nurse will fill in some paperwork and do some clinical observations-like blood pressure and pulse. The Radiologist will come and explain the procedure and sign off the Consent form with you. This is where you can talk to the Radiologist doing your procedure and they will be able to address any concerns you may have.
You will be asked to put on a hospital gown.
We want to involve you in all the decisions about your care and treatment. If you decide to go ahead with procedure, by law we must ask for your consent and will ask you to sign a Consent form. This confirms that you agree to have the procedure and understand what it involves.
The consent form is a form that both you and the operating doctor sign confirming that you have discussed the procedure and been informed of the risks/benefits/alternatives and have agreed to carry on with the interventional procedure. (You can have a copy of this form to take with you.)
Please feel free to ask any questions that you may have and, remember that even at this stage, you can decide against going ahead with the procedure if you so wish.
The radiologist will look at your liver using an ultrasound machine and plan how they will be performing the biopsy. After this they will prepare all the equipment for the biopsy.
Your skin is cleaned with an antiseptic solution and covered with sterile towels. Local anaesthetic is injected into the skin and muscles lying over the liver. The anaesthetic stings for a few seconds before the area will go numb. This means that you are awake for the procedure, but the area is numb and you should not feel any pain. It is possible to be sedated before the procedure if you are particularly anxious, but this is very rarely necessary.
The doctor uses a special needle to remove a small piece of liver tissue. They put the needle through the skin over the liver on the upper right side of your tummy (abdomen).
The sample of liver tissue will be examined under a microscope in a laboratory. The wound site is cleaned, and a dressing is placed over it.
The pain is reduced by using local anaesthetic. You may have some abdominal or shoulder pain after the biopsy, but painkillers can be given whenever you need them.
After the biopsy you will be asked to lie in bed for 6 hours. Whilst in the recovery area, the recovery nurse will check your blood pressure and heart rate which is part of standard post procedure care. You will be allowed to eat and drink normally around 1 hour after the procedure.
If you are not staying overnight the recovery team will discharge you after 6 hours if you remain well. You will need a responsible adult to take you home by car or taxi, and they will need to stay with you overnight. We recommend that you do not use public transport, however if this cannot be avoided, please be wary of people bumping into you and take particular care near the biopsy needle entry site.
When you arrive home
Please follow the advice and instructions from your doctors and nurses.
- Rest at home for the remainder of the day and the next day, depending on how you recover.
- Eat and drink as usual.
- Take your usual painkillers, as prescribed, if you have any pain.
- Continue taking any usual medicines, as prescribed
- Check the area where the needle was placed (the biopsy site) regularly to ensure no new bleeding.
- You may feel some discomfort at the biopsy site for a couple of days after the procedure which should settle with simple pain killers like paracetamol.
If you have been asked to stay in hospital overnight after the biopsy, you will be looked after on one of the hospital wards by the doctors who requested the biopsy. You will be reviewed and sent home the following morning. Please ensure you bring your regular medications with you.
The results take about 7-10 working days and will be sent to your referring doctor. You need to make an appointment with the doctor that referred you to discuss your results. We do not issue results over the telephone.
Research Biopsy Results
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 the same procedure as a non-research biopsy and the risks are the same.
The results take about 7-10 working days and will be sent to your referring doctor. You need to make an appointment with the doctor that referred you to discuss your results. We do not issue results over the telephone.
Research Biopsy Results
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 the same procedure as a non-research biopsy and the risks are the same.
The results take about 7-10 working days and will be sent to your referring doctor. You need to make an appointment with the doctor that referred you to discuss your results. We do not issue results over the telephone.
Research Biopsy Results
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 the same procedure as a non-research biopsy and the risks are the same.
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Page last updated: 19 February 2026