ObjectiveTo systematically review the risk factors of post transplantation diabetes mellitus (PTDM) after liver transplantation for adult to provide clinical prevention and treatment basement on it.MethodsPubMed, Web of Science, The Cochrane Library (Issue 5, 2016), CNKI, VIP and WanFang Data were searched from inception to May 2016 to collect observational studies about risk factors of post transplantation diabetes mellitus (PTDM) after liver transplantation for adult. According to the inclusion and exclusion criteria, two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed using RevMan 5.3 software.ResultsA total of 39 studies were included, which involving 10 043 adults. The incidence of PTDM was 27.61% (2 773/10 043). The results of meta-analysis showed that the following significant recipient factors: male (OR=1.53, 95%CI 1.32 to 1.78, P<0.000 01), advanced age (MD=3.82, 95%CI 2.74 to 4.89, P<0.000 1), higher BMI (MD=1.24, 95%CI 0.50 to 1.97, P=0.000 9), higher weight (MD=4.35, 95%CI 1.92 to 6.78, P=0.000 5), higher FPG before transplantation (MD=6.79, 95%CI 3.51 to 10.06, P<0.000 1), family history of diabetes (OR=1.62, 95%CI 1.13 to 2.31, P<0.008), HCV(+) infection (OR=2.44, 95%CI 1.88 to 3.17, P<0.000 01), CMV(+) infection (OR=2.75, 95%CI 1.67 to 4.50, P<0.000 1). The donor factors are male (OR=1.25, 95%CI 1.01 to 1.54, P=0.04), liver steatosis (OR=1.68, 95%CI 1.28 to 2.20, P=0.000 2), CMV(+) infection (OR=2.07, 95%CI 1.05 to 4.11, P=0.04), DDLT (OR=3.83, 95%CI 1.72 to 8.55, P=0.001). There were significant postoperative factors such as early acute rejection (OR=1.84, 95%CI 1.33 to 2.55, P=0.000 2), early infection (OR=4.16, 95%CI 1.94 to 8.92, P=0.000 2) and the use of tacrolimus (OR=1.50, 95%CI 1.23 to 1.83, P<0.000 1).ConclusionThe risk factors of PTDM include recipient factors such as male, advanced age, higher BMI, higher weight, higher FPG before transplantation, family history of diabetes, HCV(+) infection, CMV(+) infection. The donor factors are male, liver steatosis, CMV(+) infection, and DDLT. The postoperative factors are early acute rejection, early infection and the use of tacrolimus. Due to limited study quality, more high quality studies are needed to verify conclusion.