Thank you for using Justanswer for your question.
I'm sorry to hear of the loss of two of your friends to this condition. Most likely when your friends started smoking it was still considered a glamerous thing to do, with little known about the long term consequences. So of course you can't really judge them or "play god" just as you said.
It looks like you have spent a lot of time reading and learning about lung transplants and lung disease by your note above. I may not be able to tell you any new statistics, but I can explain them from a health care provider's view, having worked in the field for a long time (30 years if you count the 5 years before I became a nurse and worked as a nursing tech)
I quit smoking within a year of graduating from nursing school. I worked ithat first year in an ICU at a mostly geriatric hospital and a large percentage of our patients happened to be there with severe COPD and due to complications and fragility, were in and out all the time. Often the whole family became familiar to staff, and so it was an awful loss to us too, sometimes after taking care of that individual so completely over several months and sometimes years. They were mostly spending their last few years, of life being weened on and off the ventilator in and out of the ICU, not a nice retirement environment. A smoker's life expectancy is not that much shorter than other individuals, but their quality of life is so much more less than desired. I think if more people were sent to tour an ICU before they started to smoke, then there would be a lot less smoking going on.
Unfortunately with most of our cities having a decline in air quality , we may not be able to stop negative effects to our lungs in the near future whether we smoke or not!
When I started as a nurse only a few lung transplants had been done. Now aproximately 1000 are done per year in the U.S. That is in comparison to 15,000 kidney transplants, 6000 liver, and 2000 heart transplants.
There are more restrictions and difficulties encountered in trying to locate suitable lungs for transplant than with some other organs.
Generally the lungs must come from young, healthy people that have had severe brain damage because of trauma or cardiac arrest. Plus, after the accident has occurred, approval for donating tissues has to be verified or obtained. The decision has to almost already been made by the individual before they die and they need to have the card on them usually, as their lungs and other organs have to be maintained at a healthy level on life support machinery if they are going to be useable. So a person or their family usually has to have gone through the loss of a healthy young person with a life ahead of them. Some families will even try to take back the permission for transplantation that an individual may have once agreed to, due to grieving and hoping that "beyond all hope" the individual will miraculously heal from the head trauma. Then, there are the arrangements that have to be made to ship the body part from someimes across the country.
One article i read stated that now sometimes two individuals can donate small parts of their lungs to a person in need. With this you can still imagine the difficulty getting two different pieces of lungs (to make one whole) from two different individuals and making sure that there is some matching between the tissues or that they respond well to the anti rejection medication - since they will have two different people's foreign tissue in their body that will need medication for suppression.
The lung or lung pieces must also come from individuals that are approximately the same size and height, in order for them to fill the cavity properly.
So these are the reasons lung transplantation is at such a lower level than other organ transplantation. One thing that needs to be done is for more volunteers to get involved in their local transplant organizations to teach about organ donation, dispel myths about it, and why it isof so much importance. As a volunteer you could speak about your loss of two friends, for example. If nothing else, this might be a charity that you would like to support by a small donation yearly, or take a donation box to your work place, etc.
Here is additional information on the transplant procedure, in case you have not seen this article:
Here is a link to the Florida LifeLink, in case you want to learn more about transplantation in your state:
I hope this is helpful, if you have additional questions on this subject, don't hesitate to reply.
Thank you and take care,