What is a liver biopsy and when is it needed?

A liver biopsy is a medical procedure in which a small sample of liver tissue is removed and examined under a microscope. It helps doctors assess the health of the liver and diagnose certain liver conditions, such as non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH). It can also be used to look for cysts, parasites, infection, or other harms to the liver. 

A doctor may order a liver biopsy if there are concerns about the patient's liver health. Abnormal liver function test results, persistent unexplained symptoms, or suspected NAFLD/NASH based on imaging studies like ultrasound or MRI are examples of reasons a doctor may order a liver biopsy.

What happens during the procedure?

During the procedure, the patient lies on their back, and a small needle is inserted through the skin into the liver to collect a tiny tissue sample. It is usually performed under local anesthesia to minimize discomfort. After the sample is removed, the patient will need to remain lying down for a few hours after the procedure. This is to help prevent bleeding from the biopsy site.

What happens after the procedure?

The biopsy sample is then examined by a pathologist to determine the presence of fat, inflammation, and liver cell damage. The results can provide valuable information about the stage and severity of NAFLD or NASH.

For patients being screened for NAFLD, the biopsy results may indicate the amount of fat in the liver and whether it has progressed to NASH. For those with NASH, the biopsy can help assess the degree of liver inflammation and fibrosis (scarring). The stage of fibrosis is crucial in guiding treatment decisions, as advanced fibrosis may lead to cirrhosis, a severe and irreversible liver condition.

In summary, a liver biopsy is a procedure used to assess liver health and diagnose liver conditions like NAFLD and NASH. The results can offer valuable insights into the stage and severity of the disease, aiding doctors in developing appropriate treatment plans for their patients.