Opponent's comments

Dr Lentine has effectively presented an argument for weight loss prior to transplant and has included a balanced view with important caveats. It should be noted that there aremany points of agreement between our ‘polar views’. Most importantly, we agree that BMI is an imprecisemeasure of obesity and surgical risk and that a ‘one size fits all’ approach is not ideal. Our opinions diverge with respect to the relative importance applied to utility versus equity of organ distribution and whether weight loss is truly a modifiable risk factor.