Solution: The main finding in this case is that there is diffuse severe vaosoconstriction of the arterial tree. There is associated narrowing of both the systemic and the visceral arterial vasculature and there were clinical symptoms of associated ischemia, including hepatic graft failure that was almost certainly related to the vasoconstriction. The cause was thought to be severe underlying infection resulting in sepsis, and hypotension (low flow state) resulting in diffuse vasoconstriction and exacerbated by the vasopressors.