Liver biopsy scoring

[Highliverenzymes]

Im currently waiting for liver biopsy results to grade my liver fibrosis. Could people who have had liver biopsies done please describe how they rated your stage of liver disease. Did they say you are at stage 3 or like more specific like you are at stage 3.4.

[TT-2018]

I had already been diagnosed end stage decompensated, due to all the symptoms, blood tests and CT and US scans. The biopsy confirmed that the diagnosis was correct.

[Hidden in reply to TT-2018]

Can I ask what we’re your symptoms please

[TT-2018 in reply to Hidden]

Bleeding varices, ascities, oedema, HE, portal hypertension, astrixes etc, etc.

I was hospitalised at the time and taken down from the ward for the biopsy.

[Hidden in reply to TT-2018]

Thank you, I was diagnosed on March 10th just by blood results, still haven’t had a biopsy. Initially it was because my clotting level was awful, now bec of covid. I hate this waiting game, I just want to know what I’m facing. I was hospitalised too but mainly because of pain, vomiting, reflux, low albumin and very high bilirubin and ALT. My GI thinks I have cirrhosis but can’t confirm till biopsy

[velvetunderground]

Liver biopsy is often referred to as the 'gold standard' for diagnosis, however you need to remember that it only samples a tiny proportion of a very large organ. It's not perfect, but used in combination with other tests can often help to confirm a diagnosis. Some on this group (including me) have had biopsies and the results are a little inconclusive as the sample wasn't good enough. Accurate diagnosis of liver disease isn't easy and typically needs a number of tests in combination along with a lot of experience in interpreting the results. Trying to gauge a 'stage' to a decimal point would be a futile and unhelpful task in my opinion - it's just a number and the liver is such a complex organ that you can't meaningfully score it to that level.

I completely understand the desire to have an accurate 'score', I would love to have one. Personally I 'judge' my progress using a variety of metrics - bloods, fibroscan, how I am feeling etc. I have also come to realise that what is important is the general direction of travel, not one particular result. If a completely healthy person was tested as often and comprehensively as some of us are, then they would find numbers going up and down too, to a large extent that is normal.

I wish you the best of luck with your journey.

Paul

[AyrshireK]

We have never been told any grading following hubby having two biopsies, we were just told he had cirrhosis - but we knew that already from ultrasound. Many folks don't get told the scores on the doors as it were.

There are several different scales that doctors use for categorizing liver damage.

Metavir Scale (F0-F4) and Ishak Scale (0-6). Fibroscan kPa scores relate to Metavir i.e. F0-F4.

You shouldn't just get a report but an explanation of what the findings mean.

Katie