Liver damage due to tylenol overdose

A friend of mine overdosed on tylenol the other day.  They say her emyzemes are up over 7,000 as of  last night.  The day before it wa at 3200.  They say she needs a liver transplant or she will die.  She is refusing the transplant because she's psychotic and believes that her ex is going to kill her, there are many people after her and she doesn't want to give him the satisfaction.  Sad sad situation.  They can't treat the craziness because those medications will have side effects that will cause more damage.   My question is .......if she does not accept a liver transplant, how much time does she have?  I'd appreciate an honest answer...Thanks....

[Thomas D Schiano, MD]

tylenol overdoses can be treated medically.  as long as she receiving the antidote NAC and she doesn't have renal failure she might recover without the need for a tranplant.