heck, it's hard to tell even if you tear it down
Guy at the local Freightliner dealer tore into his 1990 at 300K, and EVERYTHING still looked new. They just dont get used hard enough in a pickup to wear.
If it has under 400K (heck, mine is fast approaching 300K), I would have no qualms about buying it, and running it another 200-300Kmi. I have driven a couple that had passed 500, and they ran about the same as mine with 160K at the time. I had the factory hone marks in mine, after 250K of pulling hard, with the pump turned up, and hot shut downs (P. O. didnt have a pyrometer on it) burning the stock turbo. Replaced head gasket, and am running it 35K and a year later.
Now the rest of the truck... ... That depends on how well it was cared for. Not so much the drivetrain (though it isnt as tough as the SuperB), but the body and suspension. The bed on mine is falling apart on both sides now, thanks in part to not replacing shocks when needed, in bigger part to going too fast (20mph) on too rough gravel roads.
Ok, neither of us has helped in your original question, but I hope we have quieted any fears you may have had about a high mileage engine. Heck, I dont even consider 200K high mileage on the engine. Truck, yes. If it starts, runs, and doesnt smoke any unusual colors, use it. These aint D-maxes or PSDs.
Daniel