Therapeutic Options in Alpha-1 Antitrypsin Deficiency: Liver Transplantation

Alpha-1 antitrypsin deficiency is the commonest genetic condition leading to liver transplantation in childhood. It remains unclear why only a minority of individuals carrying homozygous PiZ phenotype has liver disease, but also why of those only about a quarter develops end stage liver disease, requiring liver transplantation. This intervention has now become routine worldwide with 1-year patient survival rates well above 90%. As for all autosomal recessive conditions liver donation from anonymous cadaveric sources is preferred to living related parental donors, due to their presumed heterozygous state.