Current Hepatology Reports

, Volume 18, Issue 3, pp 287–293 | Cite as

The Role of Liver Biopsy in Drug-Induced Liver Injury

  • David E. KleinerEmail author
Drug-Induced Liver Injury (P Hayashi, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Drug-Induced Liver Injury


Purpose of Review

This review presents the current understanding of the role played by liver biopsy in the diagnosis and management of drug-induced liver injury (DILI).

Recent Findings

While liver biopsy remains an optional procedure in the evaluation of DILI, it has the potential to provide detailed information about the state of the liver. Recent histological surveys of DILI provide a framework for categorizing the patterns of injury that may be seen. Pattern information can be used to distinguish DILI from other potential causes of injury, both other acute injuries as well as pre-existing injury. The pattern of injury is related to differential diagnosis and in some cases can suggest a mechanism of injury. The character and severity of the injury could potentially be used in clinical decision-making. Examples of the use of liver biopsy in the context of DILI encountered in clinical trials are provided which highlight these points.


Liver biopsy may be a useful tool in DILI evaluation, particularly in complex clinical situations and clinical trials with experimental therapies.


Hepatotoxicity Acute hepatitis Cholestasis Checkpoint inhibitor Clinical trial 



Dr. Kleiner prepared the manuscript, including all figures and tables.

Funding Information

This review was financially supported by the Intramural Research Program of the NIH, National Cancer Institute.

Compliance with Ethical Standards

Conflict of Interest

David E. Kleiner declares no potential conflicts of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© This is a U.S. government work and not under copyright protection in the U.S.; foreign copyright protection may apply 2019

Authors and Affiliations

  1. 1.Laboratory of PathologyNational Cancer InstituteBethesdaUSA

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