[HSF] postop hepatorenal insufficiency

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Opinion requested,
37 y/o male Bicuspid aorta and root 5 cm,ascending aorta 5.3 cm,Mitral regurg,EF 15-20%
OPerated:aortic button modification of bentall+ mitral ring annuloplasty,Continous antegrade cold hyperkalemic blood crpl for most of the operation,weaned from CPB with IABP( inserted in the 3.rd trial for weaning) and high dose inotropic support(CPB time 230 minutes).Moderate oozing from the root( no bioglue) and unfortunately mechanical failure of the only CATS(autotransfusion) available.+ units of FFP and 4 units of whole blood( Htc 21 when weaned from CPB)packed with sponges and closure of the skin and taken to ICU.gradual weaning from inotrops in 20 hours.
Postop1.st day morning:Creatinin 1.4,AST470,ALT 290,ABG perfect
Open in the ICU and took the sponges and culture of mediastinum .uneventful and finished in 20 minutes.
Repeat lab on evening:CRE 3.2,AST 4900 ALT9048,INR2.1,ABG:PO2 67(FIO2 %70),Left atrial pressure 18 mmHg,BP 110/80( no inotrops),renal shut down in hours and unremitting fever( despite everything).Stared peritoneal dialysis but doesnt work. started CVVHDF( good function)
POstop 2.nd day( today):hemodynamics stable( no inotropes),Dopamine(3 micro),PO2 70(FIO2 %80,pressure support ventilation) still oliguric(40 cc/6 hrs),Cre 3.8,AST 1270,ALT5342,He is awake but sedated and paralysed.no growth in cultures
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