The team are prepared to do a domino surgery that Helen has had in the works for months that requires the relatives of sick people who need livers to donate a piece of theirs to help others so their relative can get one in return.

The surgery requires two other cities. Everything is set to go when Iggy has to do psych evaluations. Tonya the sister of one of the donors backs out because she doesn't feel her brother would do the same for her

The rest of then scramble to get the chain back on track before the other cities pull out. Max hopes that the others will donate including Tariq who is the husband of the woman who is the reason behind the domino chain. Tariq refuses to donate when he realizes his wife won't get her liver.

Lauren's patient gianna is an undocumented immigrant who needs a lung transplant. She can't get one because her status keeps her from being on the donor list. Her father is a match for the chain, so he volunteers no question to donate part of his liver in exchange for a lung.

They have 12 donors for her, but her heart fails and she isn't ready for surgery. Diego still chooses go donate because it's the right thing to do. When he wakes up, gianna had the surgery.

The domino surgery is a success.

Genna is finally able to move in with Blanca but almost ruins it when she's afraid it won't last.

Helen, Max, and Georgia go over Max's treatment plan and both ladies convince him to go through with one of the surgeries. Georgia takes care of him when he does and reassures him that they'll make it through when he has doubts.

Lauren reassures Floyd that things are normal between them and she's okay with him dating Evie. She refuses go go home though.