A 55-year-old male with cirrhosis and end-stage liver disease secondary to alcohol abuse and hepatitis C presents for cadaveric transplant. His current MELD (model for end-stage liver disease) score is 33. The donor is a 35-year-old male with an intracerebral hemorrhage who underwent donation after cardiac death (DCD) organ harvesting. After reperfusion of the portal vein, the patient experiences profound, sustained hypotension resistant to all standard vasopressor medications.

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