Candidates for organ transplant are thoroughly screened, and illicit substance use is usually disqualifying. But cannabis is well established as a medicine (as it has been for millennia) and should not prevent patients from receiving a necessary transplant. Doctors at a pediatric hospital in Delaware recently described the thought process around allowing or prohibiting cannabis use. An adolescent woman was managing her anxiety with cannabis and had a kidney disease. The transplant team’s main concerns were the possibility of aspergillus infection and PCP contamination on cannabis. The fear with aspergillus is that patients on immunosuppressive medication will be more susceptible to harm. But there have only been three established cases of aspergillus infection from cannabis in the past 30 years. And the concern about PCP is hard to understand — there are no reports of people accidentally using PCP-laced cannabis. To ensure the safety of her cannabis, the patient was not placed on the transplant list until she enrolled in her state medical cannabis program. But the doctors discuss how even this requirement is problematic — not every state has a medical cannabis program, and the ones that do don’t always protect cannabis-using patients from discrimination. A more realistic concern is that a transplant patient may use isolate CBD in high doses. Moreover, as Project CBD has highlighted, states like California allow “¼ of the [cannabis product to be] covered by mold”, which can hardly be considered sufficient protection. Finally, the doctors highlight data indicating that cannabis is safe in transplant patients. Studies that compare cannabis users to non-users find equivalent rates of complications. And cannabinoids are even being studied to prevent graph versus host disease, a life-threatening reaction to organ rejection.