A 40-year-old man with a history of autoimmune kidney disease (IgA nephropathy) is experiencing a decline in kidney function with his glomerular filtration rate (GFR) now at 17 mL/min and creatinine...

A 40-year-old man with a history of autoimmune kidney disease (IgA nephropathy) is experiencing a decline in kidney function with his glomerular filtration rate (GFR) now at 17 mL/min and creatinine at 5.2 mg/dL. He has had three recent episodes of hyperkalemia. He started home dialysis and has been on the kidney waiting list for 5 months. The average wait time in his area is 3 to 4 years. His wife and he have discussed her donating a kidney to him, but have been concerned about living kidney donation because they have two small children and no family in the area to care for them. Friends and neighbors come forward and offer to care for the children while they are hospitalized. His wife is evaluated and found to be a compatible match for living donation. A date is set with the transplant hospital and arrangements for child care are made. Both recover quickly with each having a serum creatinine of 1.8 mg/dL at discharge. The wife is discharged to home after 2 days. The husband is discharged to home after 5 days. On postoperative day 14, a routine clinic visit reveals a creatinine increase to 2.8 mg/dL with tenderness over the new kidney site. A renal biopsy is performed revealing a Banff 2 rejection. What is the best treatment option for this patient?