Liver Biopsy Questions

Does anyone know about liver biopsies? I was wondering, because I may have to have one...do they sedate you? Is there a recovery time? How long does it normally take to get the results? Sorry, but I have been told I have Hep C and it has progressed into Cirrhosis, they need the biopsy to find out just how far. Thanks for the help.

[KjFlicka]

I don't think they can determine how bad your cirrhosis is by blood test. It would merely be a good guess. And they certainly can't tell if you have liver cancer by a blood test.

They are no big deal!!  There is for sure sedation and, if memory serves, I think they started mine up at my neck and travelled down the vein with a tiny nipper needle... but that is just one way.

Good luck!

[rpooo]

I dont know much about the biopsy since I have never had one but I do have cirrhosis and I know it can be determined how bad your cirrhosis is by having blood tests. That is how mine has been determined. With a biopsy you run the risk of infection and not something you want if you have cirrhosis. You should question your doctor as to why a biopsy would be requied vs blood work. I wish you the best. God bless you
Randy

[nananeedsthis]

  Thanks...I'm not sure why the biopsy either, but it is something they have mentioned. I have not seen the gastroenterologist yet, and he will be the one who will decide if I need one or not. Just going by what my doctor mentioned. I have had a ton of blood work, in fact so much I don't think there is a spot on my arms that hasn't been poked. I have also had an ultrasound, but I am waiting for the results, which I should get Wednesday. Thanks for the wishes, I just may need them...

[KjFlicka]

I don't think they can determine how bad your cirrhosis is by blood test. It would merely be a good guess. And they certainly can't tell if you have liver cancer by a blood test.

They are no big deal!!  There is for sure sedation and, if memory serves, I think they started mine up at my neck and travelled down the vein with a tiny nipper needle... but that is just one way.

Good luck!

[rpooo]

Through a blood test they can certainitly tell exactly what amount of progression the cirrhosis has made. Taking a biopsy of any organ in your body is a very big deal. Although the liver would be the best organ since it has the ability to heal itself. Using blood work and a CT Scan can determine if you have cancer.

Anyway I am certainitly not a medical professional by any means. I speak to you from what I have experienced and what I have been able to learn on my own reading about my disease and the best way I can inturpet it.

[mikesimon]

What you describe is not a typical or routine needle liver biopsy - percutaneous liver biopsy

Your biopsy appears to have been a Transjugular Liver Biopsy. This procedure is used when there is a concern about the risk of bleeding, ascites, obesity etc.. A catheter is inserted at the neck into the jugular vein and then guided by ultrasound into the hepatic vein and then a hollow needle is inserted into the liver and a tissue sample is obtained. With this procedure if there is a bleed the blood flows into the hepatic vein.

A percutaneous biopsy is pretty straight forward. Often a hollow needle is inserted between the ribs into the liver and a sample of liver tissue is obtained. This procedure can also be ultrasound guided which is the best way in my opinion but it can be performed without any imaging help. I have had a lot of biopsies and the majority were in my hospital room with nothing to guide the procedure other than the doctor's skill. They all went fine.

At advanced stages of cirrhosis often there is no need to biopsy the patient. The blood test results and the physical examination and patient history make it clear that there is cirrhosis present. I had a liver transplant and was never biopsied beforehand and I was listed 5 years before my transplant. Generally you'll see an enlarged spleen, a stiffer liver, a low platelet count, a slow clotting time and other laboratory and physical signs such as edema, ascites etc.

A liver biopsy is still the gold standard for assessing liver histology and it is especially useful in the decision making process whether or not to treat hepatitis c. It appears as though new treatments for HCV are close at hand so if a patient's liver has mild to moderate damage some physicians will lean toward waiting to treat hoping the newer drugs will be available. There is a risk with biopsies but I think the risk is rather small. I think I have had 8 with no problem at all. The worst part for me is waiting for the results.

I too am not in the medical profession and, like Randy, what I know I learned through the patient perspective.

Mike

[nananeedsthis]

  Thanks for the information...I believe the kind of biopsy the doctor is talking about is the direct one into the liver through the rib cage. I do know that the cirrhosis is farther along than they would have liked, but today when I went in for the follow up...they said they felt that I would be a better candidate for treatment vs. transplant. They are taking all of the reports to the gastro. and of course he will have more information for me. I do know that they suspect I have had this a very long time, and I just found out that my half-brother also had it, but went through the treatment (his was caught earlier). We both suffered the same cutting abuse, and I suspect that is where we got it. Neither of us have been drug users, excessively sexually active, or have had any of the known risk factors, except the cutting that our father did to us...but then, I am probably hurting myself more trying to figure out where I got it rather than trying to figure out how to get rid of it.  I thank you for your help, it is greatly appreciated.

Dawn

[rpooo]

Hi Dawn, again I wish you the best. God bless you. Remember to always share with your doctor as much imformation as you can pertaining to your illness. This will help him/her better decide the best treatment for you. :)

Mike always good to see you out here! You truley are one of Medhelp's great secrets. Medhelp can not pay for people that put their heart into helping others here in the forum like you do.
Thank you, God bless!
Randy

[mikesimon]

Thanks Randy. It's nice to see you as well. You're helping people too and that is great to see.

Dawn, I neglected to respond to your questions and got carried away on the biopsy rant.

I believe that most facilities do offer some type of sedation prior to biopsy - maybe a twilight drug like Versed or Propofol. They also inject a drug to desensitize the skin and deeper tissue at the biopsy site. I never had any twilight drugs drugs but I did always have the injections prior to my biopsies. I would get one injection probably a fraction of an inch into the skin and a second injection with a longer needle to anesthetize the deeper tissue and then finally the biopsy needle.

After the procedure you will have to lie down for 2 to 3 hours so they can be sure you are not bleeding. This is done with all patients - not just cirrhotic patients.

The results will probably be ready in a few days but don't be surprised if you don't get them for a week or so.

Again I am just a layperson so my advice isn't worth a whole lot but I will say this. Keep you own parts if at all possible. I was lucky to get a liver and I know that. I was very lucky to clear the hepatitis c after transplant but it took me a while to do so. After a transplant the virus attack the new liver. It can be, and often is, much more aggressive and transplant recipients usually have a significantly lower tolerance to treatment and consequently lower odds of success.

Good luck Dawn,
Mike

[nananeedsthis]

Thanks Mike...advice well worth listening to. Looks like things are going my way anyway. Lets just hope things keep going in that direction. I'll let you both know more as I get more news from the docs.

Thanks...Dawn