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.
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:
ξ Coumadin® (warfarin),Plavix® (clopidogrel), and Brilinta® (ticagrelor) should be
stopped 5 days before the biopsy.
ξ Effient® (prasugrel) should be stopped 7 days before the biopsy.
ξ Pradaxa® (dabigatran) should be stopped 2 days before the biopsy.
ξ Xarelto® (Rivaroxaban) should be stopped 24 hours to 72 hours before the biopsy, you
will need to discuss this with your coordinator. The timing is different depending on why
you take this medication.
Again, we do not want to stop any of these medicines without first talking to the doctor who
prescribed them for you.
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.
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®,
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
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.
2. Next, report to the Transplant Clinic. You will have an IV started in the Transplant
clinic, and 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
2. The biopsy site will be covered by a Band-Aid®. It will also have a sandbag on it for the
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 results, 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.
2. Plan quiet activities when you get home. No driving for the rest of the day. Avoid any
alcohol use, as always.
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 θ F.
Transplant Clinic (608) 262-5420 Monday-Friday
8:00 a.m. - 5:00 p.m.
Paging Operator (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.
Your health care team may have given you this information as part of your care. If so, please use it and call if you
have any questions. If this information was not given to you as part of your care, please check with your doctor. This
is not medical advice. This is not to be used for diagnosis or treatment of any medical condition. Because each
person’s health needs are different, you should talk with your doctor or others on your health care team when using
this information. If you have an emergency, please call 911. Copyright ©1/2016. University of Wisconsin Hospitals
and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#4213.