Ke-You (Yoyo) Zhang
Clinical Assistant Professor, Pediatrics - Gastroenterology
Clinical Focus
- Pediatric Intestinal Transplant
- Intestinal Failure
- Pediatric Liver Transplant
- Hepatology
- Pediatric Gastroenterology
Administrative Appointments
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Medical Director of Intestinal Transplant, Stanford Children's Health (2022 - Present)
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Medical Director of Vascularized Composite Tissue Transplant Program, Stanford Univversity (2023 - Present)
Honors & Awards
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Invited Guest Editor, Human Immunology (2024)
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Top Clinical Abstract, Congress of the Intestinal Rehabilitation and Transplant Association (2023)
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Oral Presentation of Distinction, AASLD The Liver Meeting (2022)
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Pancreas Scholar, Collaborative Alliance for Pancreatic Education and Research (CAPER) (2019-2021)
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Ernest and Amelia Endowed Fellow, Maternal & Child Health Research Institute (MCHRI) (2019-2021)
Boards, Advisory Committees, Professional Organizations
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Member, Intestine Subcomittee, American Society of Transplant (2024 - Present)
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Member, Scientific Steering Committee, Intestinal Rehabilitation and Transplant Association (IRTA) (2023 - Present)
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Member, Hepatology Committee, North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (2024 - Present)
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Member, International Pediatric Transplant Association (IPTA) (2021 - Present)
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Member, Society of Pediatric Liver Transplantation (SPLIT) (2021 - Present)
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Member, North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (2018 - Present)
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Member, American Academy of Pediatrics (2015 - Present)
Professional Education
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Fellowship: Stanford University Pediatric Gastroenterology (2022) CA
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Board Certification: American Board of Pediatrics, Pediatric Gastroenterology (2021)
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Fellowship: Stanford University Pediatric Gastroenterology (2021) CA
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Board Certification: American Board of Pediatrics, Pediatrics (2020)
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Residency: Stanford University Pediatric Residency at Lucile Packard Children's Hospital (2018) CA
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Medical Education: University of Connecticut School of Medicine Registrar (2015) CT
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Fellowship, Stanford University Pediatric Gastroenterology (2021)
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Residency, Stanford University Pediatric Residency (2018)
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MD, University of Connecticut, Medicine (2015)
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Post-Baccalaureate, University of Pennsylvania, Pre-Med (2010)
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BA, Boston College, English (2008)
Clinical Trials
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A Study of NST-6179 in Adult Subjects With Intestinal Failure-Associated Liver Disease (IFALD).
Recruiting
This is a phase 2a, multicenter, randomized, double-blind, placebo-controlled study to evaluate the safety, tolerability, pharmacokinetics (PK), and pharmacodynamics (PD) of NST-6179 in adult subjects with intestinal failure-associated liver disease (IFALD) receiving parenteral nutrition (PN). The study will be conducted in 2 sequential parts. Up to 36 adult subjects diagnosed with IFALD will be enrolled in the study, of which 18 subjects will be enrolled in each of the 2 parts and randomized (2:1) to receive NST-6179 (N=12/part) or matched placebo (N=6/part). Subjects in Part A will receive once daily (QD) oral administration of 800 mg (32 mL solution) NST-6179 or placebo for 4 weeks. The NST-6179 dose for Part B is planned to be 1200 mg QD for 12 weeks. Actual dose, however, will be determined during the safety review meeting.
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Expanded Access for Use of ExoFlo in Abdominal Solid Organ Transplant Patients
Not Recruiting
This Expanded Access Protocol will provide access to the IMP ExoFlo for patients who have severe or life-threatening abdominal solid organ transplant rejection or who are evaluated and determined to be at high risk of progression to severe or life-threatening condition related to rejection of an abdominal solid organ transplant, at risk of worsening allograft function, or at risk of complications from current immunosuppressive therapeutic regimens.
Stanford is currently not accepting patients for this trial.
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Umbrella Trial Testing Integrative Subtype Targeted Therapeutics in Estrogen Receptor Positive, HER2-Negative Breast Cancer
Not Recruiting
The purpose of this study is to learn if adding a new drug that is targeted at a specific genetic change found in some breast tumors pre-operatively will slow the growth of the tumor more than standard anti-hormone therapy used to treat this type of breast cancer. Different therapies are being tested based on the specific gene changes in the tumor. Not every tumor will have a gene change that is being studied.
Stanford is currently not accepting patients for this trial.
2024-25 Courses
- Childhood Chronic Illness: Impact on Family Development
PEDS 281 (Aut, Win, Spr) -
Prior Year Courses
2023-24 Courses
- Childhood Chronic Illness: Impact on Family Development
PEDS 281 (Aut, Win, Spr)
- Childhood Chronic Illness: Impact on Family Development
All Publications
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Pediatric Combined Heart-liver Transplantation: A Single-center Long-term Experience.
Transplantation direct
2024; 10 (9): e1696
Abstract
Combined heart liver transplant (CHLT) continues to gain attention as a surgical treatment for patients with end-stage heart and liver disease but remains rare. We present our institutional longitudinal experience with up to 14 y of follow-up, focused on long-term outcomes in CHLT recipients.We conducted a single-institutional, retrospective review from January 1, 2010, to December 31, 2023, including 7 patients ages 7-17 y who underwent CHLT.Most patients were surgically palliated via Fontan procedure pretransplant (n = 6), and all had evidence of advanced fibrosis or cirrhosis before transplant. The 30-d mortality was 14.3% (n = 1, multiorgan failure). During the follow-up period, 1 patient developed acute heart rejection which required treatment and 2 developed acute liver rejection. In all cases, rejection was successfully treated. Two patients developed acute heart rejection which did not require treatment (grade 1R). No patients developed chronic or refractory rejection. No patients developed allograft coronary artery vasculopathy.CHLT remains a rarely performed treatment for pediatric patients with end-stage heart and liver disease, but our long-term data suggest that this treatment strategy should be considered more frequently.
View details for DOI 10.1097/TXD.0000000000001696
View details for PubMedID 39165490
View details for PubMedCentralID PMC11335332
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Precision Delivery of Therapeutics to the Intestine: A Case Series of Superselective Steroid Administration in Pediatric Intestinal Transplant Recipients.
Transplantation
2024; 108 (8): e202-e203
View details for DOI 10.1097/TP.0000000000005053
View details for PubMedID 39042371
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Mesenchymal stem cell-derived extracellular vesicles for the treatment of acute rejection in pediatric and adult bowel transplant
AMERICAN JOURNAL OF TRANSPLANTATION
2024; 24 (4): 693-696
View details for DOI 10.1016/j.ajt.2023.10.019
View details for Web of Science ID 001217324600001
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Temporal Analysis of Inflammatory Bowel Disease and Pancreatitis Co-Occurrence in Children and Adults in the United States.
Clinical and translational gastroenterology
2023
Abstract
Pancreatitis in inflammatory bowel disease has been attributed to peripancreatic intestinal disease and/or drug-induced pancreatic toxicity. We used large cohort analyses to define inflammatory bowel disease and pancreatitis temporal co-occurrence with a detailed descriptive analysis to gain greater insight into the pathophysiological relationship between these two diseases.Truven Health MarketScan private insurance claims from 141,017,841 patients (<65 years-old) and 7,457,709 patients from four academic hospitals were analyzed. We calculated prevalence of Crohn's disease or ulcerative colitis with acute or chronic pancreatitis and performed temporal and descriptive analyses.Of 516,724 inflammatory bowel disease patients, 12,109 individuals (2.3%) had pancreatitis. Acute pancreatitis was 2-6x more prevalent than chronic pancreatitis. In adults, acute pancreatitis occurred equally among Crohn's disease and ulcerative colitis (1.8-2.2% vs. 1.6-2.1%, respectively), whereas in children, acute pancreatitis was more frequent in ulcerative colitis (2.3-3.4% vs. 1.5-1.8%, respectively). The highest proportion of pancreatitis (21.7-44.7%) was at/near the time of inflammatory bowel disease diagnosis. Of these, 22.1-39.3% were on steroids at the time of pancreatitis. Individuals with chronic pancreatitis or recurrent pancreatitis hospitalizations had increased risk of a future inflammatory bowel disease diagnosis (odds ratio=1.52 or 1.72, respectively).Pancreatitis in inflammatory bowel disease may not simply be a drug adverse event but may also involve local and/or systemic processes that negatively impact the pancreas. Our analysis of pancreatitis before, during, and after inflammatory bowel disease diagnosis suggests a bi-directional pathophysiologic relationship between inflammatory bowel disease and pancreatitis, with potentially more complexity than previously appreciated.
View details for DOI 10.14309/ctg.0000000000000628
View details for PubMedID 37556391
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Extracorporeal Photopheresis for Refractory Rejection in Intestinal Transplantation
LIPPINCOTT WILLIAMS & WILKINS. 2023: 29
View details for DOI 10.1097/01.tp.0000945660.23307.c7
View details for Web of Science ID 001023645700047
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Mesenchymal stem cell-derived exosomes for the treatment of acute rejection in pediatric and adult bowel transplant
LIPPINCOTT WILLIAMS & WILKINS. 2023: 38
View details for DOI 10.1097/01.tp.0000945716.40222.b5
View details for Web of Science ID 001023645700061
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MELD 3.0 for adolescent liver transplant candidates.
Hepatology (Baltimore, Md.)
2023
Abstract
Adolescents constitute a unique waitlist cohort that is distinct from younger children. MELD 3.0, which was developed in an adult population of liver transplant candidates, is planned to replace MELD-Na in the current liver allocation system for both adult and adolescents aged 12-17. We evaluated the predictive performance of MELD-Na, MELD 3.0, and PELD, for 90-day waitlist mortality risk among adolescent liver transplant registrants.New waitlist registrations for primary liver transplant among individuals aged 12-17 and aged 18-25 for comparison were identified using OPTN data from Nov 17 2004 to Dec 31 2021. The predictive performance of the current and proposed MELD and PELD scores was assessed using the Harrell's concordance (c) statistic.There were 1,238 eligible listings for adolescents aged 12-17, and 1,740 young adults aged 18-25. In the adolescent group, 90-day survival was 97.8%, compared to 95.9% in those aged 18-25 (log-rank p = 0.005), with no significant differences when stratified by sex or indication. Among adolescents, increasing MELD 3.0 was associated with an increased hazard of mortality (HR 1.27, 95% CI 1.18-1.37), and the c-statistic for 90-day waitlist survival using MELD 3.0 was 0.893, compared with 0.871 using MELD-Na, and 0.852 using PELD.The discriminative ability of MELD 3.0 to rank adolescents according to the risk of death within 90 days was robust. Although MELD 3.0 was initially developed and validated in adults, MELD 3.0 may also improve the prediction of waitlist mortality in adolescents and better represent their urgency for liver transplant.
View details for DOI 10.1097/HEP.0000000000000352
View details for PubMedID 36943091
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MELD 3.0 PREDICTS WAITLIST MORTALITY RISK IN ADOLESCENT LIVER TRANSPLANT REGISTRANTS
WILEY. 2022: S17-S18
View details for Web of Science ID 000870796600018
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Superior Mesenteric Artery Syndrome in an Adolescent With Anorexia and Suspected Pancreatitis.
JPGN reports
2022; 3 (2): e194
View details for DOI 10.1097/PG9.0000000000000194
View details for PubMedID 37168901
View details for PubMedCentralID PMC10158292
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Towards identifying predictors of pediatric heart only versus combined heart liver transplantation
WILEY. 2022
View details for Web of Science ID 000783167500071
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A Unified Treatment Algorithm and Admission Order Set for Pediatric Acute Pancreatitis
JOURNAL OF PEDIATRIC GASTROENTEROLOGY AND NUTRITION
2019; 68 (6): E109–E111
View details for DOI 10.1097/MPG.0000000000002341
View details for Web of Science ID 000480695000008
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A Unified Treatment Algorithm and Admission Order Set for Pediatric Acute Pancreatitis.
Journal of pediatric gastroenterology and nutrition
2019
View details for PubMedID 30921257
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Procalcitonin as a Predictive Marker for Bacteremia in Children With a Central Line and Fever.
Hospital pediatrics
2019
Abstract
Unnecessary use of antibiotics is an increasing problem. In this study, we sought to determine the diagnostic accuracy of procalcitonin in predicting bacteremia in children with a central line and fever, and we sought to determine optimal cutoff values to maximize sensitivity and specificity. This is the largest study to date in which procalcitonin is examined as a predictive marker of bacteremia in pediatric patients with a central line and fever.We conducted a retrospective cohort study of children aged 0 to 23 years with a central line and fever of 38°C who had procalcitonin and blood cultures drawn before initiation of antibiotics and had no other identified bacterial infection. Patients were also prospectively monitored via a custom-built electronic medical record dashboard for eligibility.There were 523 patients and >2500 procalcitonin values reviewed for eligibility. Of these, 169 (47%) patients and 335 blood cultures with procalcitonin were included. There were 94 (28%) positive bacterial blood cultures and 241 (72%) negative bacterial blood cultures. In bacteremic cultures, the mean procalcitonin level was 9.96 ± 15.96 ng/mL, and the median procalcitonin level was 4.85 ng/mL (interquartile range 18.5). In nonbacteremic cultures, the mean procalcitonin level was 1.23 ± 10.37 ng/mL, and the median procalcitonin level was 0.3 ng/mL (interquartile range 0.7). A receiver operating characteristic analysis indicated a procalcitonin level of ≥0.6 ng/mL as the best cutoff point that produced a sensitivity of 85.6% and a specificity of 65.7% (area under the curve 0.85).Procalcitonin is a sensitive biomarker in predicting bacteremia in children with a central line and fever.
View details for PubMedID 31097470
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Nationwide Trends in Acute and Chronic Pancreatitis Among Privately Insured Children and Non-Elderly Adults in the United States, 2007-2014
GASTROENTEROLOGY
2018; 155 (2): 469-+
View details for DOI 10.1053/j.gastro.2018.04.013
View details for Web of Science ID 000440023400042
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Nationwide Trends in Acute and Chronic Pancreatitis Among Privately Insured Children and Non-Elderly Adults in the United States, 2007-2014.
Gastroenterology
2018
Abstract
Epidemiologic analyses of acute and chronic pancreatitis (AP and CP) provide insight into causes and strategies for prevention, and affect allocation of resources to its study and treatment. We sought to determine current and accurate incidences of AP and CP, along with the prevalence of CP, in children and adults in the United States.We collected data from the Truven MarketScan Research Databases of commercial inpatient and outpatient insurance claims in the United States from 2007 through 2014 (patients 0-64 years old). We calculated the incidences of AP and CP, and prevalence of CP, based on International Classification of Diseases, Ninth Revision (ICD-9) diagnosis codes. Children were defined as 18 years or younger and adults as 19 to 64 years old.The incidence of pediatric AP was stable from 2007 through 2014, remaining at 12.3/100,000 persons in 2014. Meanwhile the incidence for adult AP decreased from 123.7/100,000 persons in 2007 to 111.2/100,000 persons in 2014. The incidence of CP decreased over time in children (2.2/100,000 persons in 2007 to 1.9/100,000 persons in 2014) and adults (31.7/100,000 persons in 2007 to 24.7/100,000 persons in 2014). The prevalence of pediatric and adult CP was 5.8/100,000 persons and 91.9/100,000 persons, respectively in 2014. Incidences of AP and CP increased with age; we found little change in incidence during the first decade of life, but linear increases starting in the second decade.We performed a comprehensive epidemiologic analysis of privately insured non-elderly adults and children with AP and CP in the United States. Changes in gallstone formation, smoking, and alcohol consumption, along with advances in pancreatitis management, may be responsible for the stabilization and even decrease in the incidences of AP and CP.
View details for PubMedID 29660323
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Plasmapheresis for Hypertriglyceridemia-Induced Acute Pancreatitis in a Child A Case Report and Brief Review of the Literature
PANCREAS
2017; 46 (7): E58–E59
View details for PubMedID 28697142