The pain from chronic pancreatitis was so debilitating a few years ago that Heidi Barragan considered dropping out of college. Her mother encouraged her to keep fighting — relying on pain medications and “learning to live with the illness.” She persevered, taking online classes and enduring repeated hospital visits.
Then in 2017, a blood clot formed in her portal vein, which carries the body’s blood to the liver to process. Doctors implanted a stent in the vein and put her on blood thinners, but her condition deteriorated.
The young San Juan Capistrano woman’s hospital visits increased to one to three times per month. Her weight plunged from 130 to 97 pounds. As her condition worsened, Barragan’s UCI Health physicians proposed a rare procedure called total pancreatectomy with islet cell auto-transplantation.
“Heidi has hereditary chronic pancreatitis, which meant she had a high lifetime risk of developing pancreatic cancer,” says Dr. Zeljka Jutric, a UCI Health surgical oncologist and islet-cell transplant specialist.
UCI Medical Center is one of a select group of hospitals in the United States — and the only one in Orange County — to perform the procedure, a program started by Dr. David K. Imagawa. The procedure involves removing the damaged pancreas, harvesting its insulin-producing islet cells and transplanting them into the patient’s liver in the hope they begin producing enough insulin to meet the body's needs.
The level of physician, surgeon and nursing excellence, along with state-of-the-art facilities at the UCI Health Digestive Health Institute, make UCI well-suited to find innovative solutions to the most challenging cases like Barragan’s, says Jutric, an expert in liver, pancreas and bile duct surgery. UCI researchers also are studying the safety and efficacy of islet cell transplantation to treat type 1 diabetes.
More frequent flare-ups
For Barragan, the episodes of pancreatitis she’d been having since middle school were getting increasingly painful.
“It’s a miserable life; you don’t know when you’ll have the next attack,” Jutric says.
Chronic pancreatitis is an inflammation of the organ that helps produce enzymes to digest food. The first step in Barragan’s treatment was to remove the pancreas, which normally leads to permanent diabetes.
The pancreas contains clusters of cells called islet cells that create hormones such as insulin, which regulates blood sugar. Although Barragan faced the risk that she would develop diabetes, she was considered a good candidate for islet cell transplantation, using her own islet cells.
“When UCI Health gave me the option of an islet cell transplant, I was shocked. I thought pancreatitis was something I would have for the rest of my life,” says Barragan, now 24. “I had developed a bond with Dr. Jutric, so I was really confident. I wasn’t scared of surgery at all.”
On March 8, 2019, Jutric performed the 14-hour operation with Dr. Ronald Wolf. After Barragan's pancreas was removed, the islet cells from her pancreas were isolated and purified by UCI Health surgeon Dr. Hirohito Ichii. Jutric then transplanted them into her liver, where they successfully continue to produce insulin.
“Heidi is so strong. In two days, she was sitting up in her hospital bed doing homework,” Jutric says.
Life without pain
Barragan has discovered a life without pain. She returned to college at Brigham Young University–Idaho in Rexburg, until the novel coronavirus pandemic closed the campus last spring. She continued her studies back home with her family and recently completed her bachelor's degree in construction management and business. She's now managing her late father's handyman business with her mother. And she's planning to get a contractor's license to expand the business.
She also has resumed her love of skateboarding and longboarding. She was even prepared to give herself insulin injections, but that hasn’t been needed.
“Now I’m pain-free and able to focus on my work and regular activities,” she says. “Before the surgery, I was always uncomfortable. It was like a stabbing pain and pressure. Eating and drinking would make it worse. I would just curl up and not move. I can do anything now. I’m eating all of my mom’s Mexican food.”
The experience, Barragan says, has made her appreciate medical research and places like UCI Medical Center that offer the latest treatments.
Barragan’s father died from complications of pancreatitis at another medical center in 2017. Until that attack, he didn’t know he had the disease. Barragan’s sister, grandfather, aunt, uncle and some cousins also have been diagnosed with chronic pancreatitis. Her aunt underwent the same surgery last spring and is doing well, Barragan says.
“Everything is really good," says Barragan. "I’m so happy I made this decision because now my family can have a solution too. They don’t have to wait for so many years before their pancreas gets worse. They can fix it now.”