We are Transplant Surgeons First, Bariatric Surgeons Second.

I greatly appreciate the time taken by the authors of the editorial to point out issues that are so very important in the field of transplantation obesity. The clinical activity and research in this field has finally reached a point where discussions of why are now almost moot and replaced with questions of how, and when. Thought is now being applied to some of the nuances to the utilization of bariatric surgery in transplantation, such as appropriate bariatric surgery procedure selection, timing of bariatric surgery in relationship to transplant, the effect of bariatric surgery on immunosuppressive absorption, and appropriate candidate selection. Yemini and Mor discuss some of these issues in their editorial response to our article, "Long-term outcomes in patients with obesity and renal disease after sleeve gastrectomy." While many of their points are well conceived, there are some that deserve more discussion.