Hidden liver harm: study tracks silent damage in genetic disorder

Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.

Liver Biopsy Group: Inclusion Criteria * Adults (≥ 18 years of age), with Alpha-1 Antitrypsin Deficiency * Documented evidence Pi-ZZ phenotype or genotype * Both genders, all races and ethnic groups * Willingness to be followed for up to 5 years Exclusion Criteria: * Evidence of advanced liver disease defined by Child-Pugh Class B or C (score ≥ 7) * Known advanced lung disease defined as forced expiratory volume at one second (FEV1) \< 40 % of Predicted * History of Organ Transplantation * Known congenital or metabolic liver disease (e.g.: Wilson's, glycogen storage, cystic fibrosis)or iron overload as evidenced by ≥ Grade 3 iron staining on a previous liver biopsy * Evidence of chronic hepatitis B (marked by the presence of HBsAg in serum) or Hepatitis C (marked by the presence of anti-hepatitis C virus (HCV) or HCV RNA in serum) * Vascular disorders of the liver (e.g.: cardiac sclerosis, acute or chronic Budd-Chiari, hepatoportal sclerosis, peliosis) * Known HIV positivity * Diagnosis of malignancy within the last 5 years * Active substance abuse, that in the opinion of the study investigator, would interfere with adherence to study requirements * Concomitant severe underlying systemic illness or medical condition which in the opinion of the investigator, would make the patient unsuitable for the study or would interfere with completion of follow-up * Inability to comply with the longitudinal follow-up as outlined in the protocol * Failure of the participant to sign informed consent or Health Insurance Portability and Accountability Act (HIPAA) documents Known Severe Liver Disease Group: Inclusion Criteria * Adults (≥ 18 years of age), with alpha-1-antitrypsin deficiency * Documented evidence PI-ZZ phenotype or genotype * Documented evidence of portal hypertension or evidence of advanced liver disease defined by Child-Pugh Class B or C (score ≥ 7), or previous liver biopsy with an Ishak Fibrosis Score ≥ 4 * Both genders, all races and ethnic groups * Willingness to be followed for up to 5 years Exclusion Criteria * History of Organ Transplantation * Known congenital or metabolic liver disease (e.g.: Wilson's, glycogen storage, cystic fibrosis) and iron overload as evidenced by ≥ Grade 3 iron staining on a previous liver biopsy * Evidence of chronic hepatitis B (marked by the presence of HBsAg in serum) or Hepatitis C (marked by the presence of anti-HCV or HCV RNA in serum) * Vascular disorders of the liver (e.g.: cardiac sclerosis, acute or chronic Budd-Chiari, hepatoportal sclerosis, peliosis) * Known HIV positivity * Diagnosis of malignancy within the last 5 years which in the opinion of the investigator, would make the patient's follow-up problematic or the results uninterpretable. * Active substance abuse, that in the opinion of the study investigator, would interfere with adherence to study requirements * Concomitant severe underlying systemic illness or medical condition which in the opinion of the investigator, would make the patient unsuitable for the study or would interfere with completion of follow-up * Inability to comply with the longitudinal follow-up as outlined in the protocol * Failure of the participant to sign informed consent or HIPAA documents. Post Liver Transplant Group Inclusion Criteria * Adults (≥ 18 years of age), with alpha-1-antitrypsin deficiency * Pre-transplant documented evidence of PI-ZZ phenotype or genotype * Documented evidence of liver transplantation * Both genders, all races and ethnic groups Exclusion Criteria * Active substance abuse, that in the opinion of the study investigator, would interfere with adherence to study requirements * Concomitant severe underlying systemic illness or medical condition which in the opinion of the investigator, would make the patient unsuitable for the study or would interfere with completion of study requirements * Failure of the participant to sign informed consent or HIPAA documents.