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. This evidence concerns the gene SERPINA1 and pulmonary emphysema.