Yes, it is serious. And seriously expensive- the actual cost is huge, regardless of the part the patient pays (I used to specialize in stop loss insurance, which is high loss reinsurance of medical risk - transplants in general are at least 100,000s and much more if things go wrong).
I hope your friend has good doctors (and good insurance) as he navigates this path. There are many people on waiting lists for all kinds of transplants so I hope he does get one if he qualifies. Since it is not drinking related (generally this disqualifies us for liver transplants), hopefully he has better chances in the "allocation" process.
Here is an article I found -
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2886399/