SERPINA1 and cirrhosis of liver: AAT deficiency (AATD) is a common genetic disorder among Caucasian populations caused by mutations in SERPINA1. Patients with AATD present with emphysema due to imbalance of elastase and anti-elastase effect of AAT, and, in some cases, accumulating AAT affects hepatic functions and leads to liver cirrhosis and hepatocellular carcinoma10, 11.