Liver‐related complications thus mainly occur in Pi*ZZ carriers, which can be considered a disease‐causing genotype, while heterozygous Pi*Z carriage is a disease‐modifying entity requiring additional hits to cause liver disease [15], such as cystic fibrosis, viral infections, alcohol‐related liver disease, or metabolic dysfunction‐associated steatotic liver disease (MASLD) [16, 17, 18]. Here, SERPINA1 is linked to liver disorder.