I had cirrhosis and a liver transplant so I think I have some insight into what is going on. Yes, your MIL is experiencing side effects from the cirrhosis which they will try to control, but these problems can pop up at any time. The hallucinations are caused by high ammonia levels since the liver cannot break them down and get rid of the ammonia like it should. The treatment for that is usually taking Lactulose which is also used for constipation. Problem is that it will cause loose bowel movements and diarrhea, but this is the way to get rid of the ammonia which is through bowel movements. Maybe she needs an increase in her dosage or they might want to try other meds that could help. I complained all the the time about the Lactulose side effects and they gave me a drug called Xifaxan which does not have the side effect of loose bowel movements but still helped bring the ammonia level down. I would use it with the Lactulose which worked much better since no one wants to have to live near a bathroom all the time. These high ammonia levels which causes hallucinations do need treated if bad enough. It leads to a condition called encephalopathy and if the ammonia goes too high, it can actually put you in a coma and be a risk to your life. Everyone has a different tolerance to these high ammonia levels. I had high ammonia but never was confused or had hallucinations.
NASH (non alcoholic steatohepatitis) is a fatty liver that has progressed to cirrhosis which is when healthy tissue in the liver is replaced with scar tissue. Your MIL most likely needs a transplant. I don't know why they have not accepted her to be listed. Did she go through an evaluation yet at a transplant center? What were their reasons for not accepting her. They will send a letter explaining their decision which is reviewed by a transplant committee. I was put on the list when my meld score was only 12 and received my transplant at 15. I was on the waiting list for 18 months. Everyone in the U.S. has to follow the rules set down by UNOS (United Network for Organ Sharing). At 15, she certainly can at least be listed as long as she passes the evaluation which consists of a lot of medical tests along with psychiatric evaluation. She must also have insurance that will approve the transplant since the surgery does cost about $300,000 these days and that is without complications.
How long can she last? Everyone is different on that too but most transplant places will give an estimate of how long. They have to know how much damage is present. A biopsy is the best test which shows everything such as the amount of damage and how severe the damage is right then. When I was first diagnosed, I was told my liver had only 10% function left and they gave me an estimate of 5 years before total failure might occur. I had mine done when my meld was 15. The surgeon told me after he saw my liver during the transplant that I had about a year left which was very close to their estimate given me when I was first diagnosed.
Your MIL really needs to try and get a transplant if she wants to stay alive. She is going to die if she doesn't get one. It's just a matter of when. What is causing her not to qualify? If she can get accepted, she has a chance of getting well again and doing fine. I have talked with a number of people in their 60's that have received transplants and did quite well. I would also suggest her to get an endoscopy done since unwanted veins called varices grow inside when you have cirrhosis due to blood not flowing right to the liver. These veins are not like the ones we are born with. They can be weak, leak, and even burst causing a crisis problem with internal bleeding. If one gets very large and bursts, the person can actually bleed to death in short time. There is a procedure called "banding" which is pretty simple to do which can get rid of these varices and greatly lower the risk of bleeding internally. I used to get an endoscopy done every 3-6 months checking mine and doing banding when needed. They do the procedure when the do the endoscopy. It's done as an outpatient and I was usually in and out within 3 hrs. or so. Nothing much to it, but they do knock you out to do it. If she has cirrhosis, she most likely has varices too.
I hope your MIL can get the help she needs. You can email me through yahoo if you have any other questions.
I had cirrhosis and a liver transplant.