Surgeons carry a recently removed organ in a cooler

From Medical Correspondent Dr. Steve Salvatore

(CNN) -- Transplant patients are living longer than ever before, but a new report finds that organs may not be distributed proportionately according to race and sex.

A look in the 1997 report, published in this week's Journal of the American Medical Association, shows graft survival and patient survival rates are up. The conditional three-year survival rate was up 90 percent for all organ transplants except lung and heart/lung.

But not everyone is reaping the benefits. In a second study of 7,125 kidney-dialysis patients in three states, researchers found women, the poor and minorities were much less likely to complete the steps of examination needed to get on a waiting list for a donated kidney.

Blacks were 32 percent to 50 percent less likely to complete the steps than whites. Women were 12 percent less likely to complete the steps than men. Poor patients were 22 percent to 33 percent less likely than the rich to complete the steps.

The study did not look at why the steps were not pursued.

"The current organ allocation system is unfair to the patients," said Secretary of Health and Human Services Donna Shalala. "You can wait literally 500 days in one part of the country, and walk off a golf course and get a liver in another part of the country."

But who gets an organ ultimately depends on organ-donor compatibility.

"There is a need if someone is to have the best graft survival for biologic matching of the donor with the recipient," said Dr. Edgar Milford of Brigham and Woman's Hospital. "And that biologic matching unfortunately, is less likely to occur when the donor is Caucasian and the recipient is black."

Dr. Ashwini Sehgal, co-author of the study, says the difference in organ distribution could be due to a variety of factors including lack of a standard ranking system of transplant patients, patients who do not want a transplant, or patients who are medically unsuitable for a transplant.

There are efforts under way to improve the allocation of organs.

Shalala says those who are sickest should get transplants first and where someone lives should not hurt his or her chances of getting a transplant.

"We need organs to follow need patients, not the organs to stay in one place and expect the patients to come to them," she said.

United Network for Organ Sharing (UNOS), which is in charge of organ sharing in the United States, opposes a national system and fears if organs are given to the sickest first, many will not survive -- resulting in organs being wasted.

The Department of Health and Human Services disagrees and insists it's only trying to set better, national standards -- and wants transplant experts to work out the details.

The Associated Press contributed to this report.