A 72 year-old female came to your office complaining of fever, fatigue, lower abdominal pain, and decreased urine output. Her past medical history is significant for dialysis dependent end-stage renal disease for 12 years and a renal transplantation 9 months ago. Your physical examination is significant for pain on the right lower abdomen. In consultation with her nephrologist, you ordered some laboratory studies and a renal transplant biopsy. Laboratory tests came positive for circulating donor-specific antibodies. In biopsy, histological examination showed microvascular inflammation, intimal arteritis, acute thrombotic microangiopathy, acute tubular injury, linear C4d staining in peritubular capillaries, and de novo glomerulonephritis. What is the most common treatment for this transplant rejection?
