Telomere Disorders and the Liver.

Telomeres are repetitive sequences at the ends of chromosomes that contribute to genome stability and prevent replicative senescence. Telomere biology disorders (TBDs) encompass a spectrum of genetic conditions characterized by accelerated telomere shortening, which affects different organs, including the liver. TBD-related hepatic manifestations are often unrecognized and can range from asymptomatic liver test abnormalities to steatohepatitis, hepatopulmonary syndrome, or cirrhotic and noncirrhotic portal hypertension requiring liver transplantation. This review summarizes the current literature and aims to describe liver involvement in TBDs, highlighting diagnostic gaps and therapeutic challenges.