These lungs were donated for transplant by a 55-year-old with an extensive smoking history. As you can see, there are visible tar deposits within the lung tissue but it was still able to be used for transplant. A shortage of organ donors for lung transplantation leads to significant mortality among patients on the wait list. To deal with the shortage of donor lungs, transplantation specialists have turned to multiple strategies, including use of lungs from extended-criteria donors, such as smokers, including heavy smokers. A smoking history of <20 pack-years traditionally has been accepted as a criterion for an ideal donor. A smoking history beyond that cutoff puts a donor into the extended-criteria category. Overall survival ranged between 80% and 95% and 3-year survival up to 82%. Donor lungs from smokers led to transplant outcomes similar to those involving lungs of nonsmokers, as transplant specialists reported. The possibility that cancer or another serious disease could evolve in a donor lung from a smoker is a concern but has rarely occurred. Considering that lung transplantation is a life-saving procedure for patients, most are willing to take any risks associated with donor lungs from smokers.
I would like to see the lungs for smokers of other non-tobacco based products such as cannabis, vape, hookah and so forth for comparison.