Dr. Nathaniel Grant is on track to become the new chief surgeon since his mentor, Chief Bart Jacobs, is ill. A teenage girl who needs a new heart is given one when a woman is fatally injured in a car accident.
Dr. Nathaniel Grant is now chief of staff of St. Jude Regional Transplant Center. As Kate Armstrong waits for clearance to approve the harvesting of organs from a Jane Doe murder victim, she spends the day with her daughter, Thea, who is stressed out about an impending dance party.
Simon makes a bad cut during a liver transplant, causing massive bleeding and forcing the staff to discard the new liver. The patient still has a chance, though, thanks to a possible living donor. But the donor is the patient's brother, who is in jail for the murder of their foster father. Meanwhile, Dr. Grant treats a 13-year-old heart transplant patient he's known for 10 years who is constantly coming back to the hospital with complications.
A controversial uterine transplant brings conflict to Dr. Grant's team while an infant's only hope for survival turns into a complex legal entanglement.
A woman with pulmonary dyspnea is in desperate need of a liver, and if she doesn't get one, her heart is going to give out. When one finally becomes available in West Virginia, Kate and Dr.
Dr. Grant and his team of surgeons are embarking on a complex "Domino" surgery, in which three married couples are donating their organs amongst each other in a six surgery process.
A hostage situation at a local video arcade results in a sheriff and a teenage girl being shot by the perpetrator, who then turns the gun on himself. The gunman becomes a potential organ donor, but the parents of the wounded girl angrily object to his organs being used.
Dr. Grant's longtime mentor and friend, has passed away, and his widow would like Grant to give the eulogy at his funeral. But Grant has difficulty finding the words.